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High blood pressure treatment is costing Australians more than $1.2 billion annually, new economic analysis shows, with patients covering 40% of the bill in out-of-pocket charges, while taxpayer funds cover the remainder through government subsidies and industry contracts.

Pharmacy fees for dispensing and handling medications accounted for about half the cost, at $611 million or 51%, according to the analysis published in on Monday, led by researchers from and UNSW Sydney.

GP appointments amounted to 29% of the cost at $342 million, while purchasing medicines from manufacturers accounted for 18% at a cost of $221 million, during the 2021/22 financial year. The remaining costs were for medicine wholesaler fees and ambulatory BP monitoring.

High blood pressure is still the leading risk factor for death in Australia, as it is a leading cause of heart attacks and stroke. With no symptoms, high blood pressure often goes undetected, yet is readily treated with medication, and diet and lifestyle improvements. 

Lead author Professor Anthony Rodgers, Professional Fellow in the Cardiovascular Program at The George Institute for Global Health, and Conjoint Professor of Global Health at UNSW said the analysis provided a snapshot of the cost of Australia’s hypertension crisis. 

“Our analysis provides a real-world snapshot of the scale of spending on the problem, and who exactly is footing the bill, to help decision-makers develop more affordable, equitable and innovative pathways to get the problem under control,” said Prof. Rodgers.  

“Two things struck us immediately: how much of the cost is going through pharmacy, and that patients are carrying an unfair share of the overall burden,” he said.

“While our concession system helps some consumers, these are real costs for people on lower incomes. Many are living with other health problems too and would face difficult choices about what medicines or health appointments they can afford. This puts their health at risk and is a fundamental barrier to Australia achieving better blood pressure control and avoiding the serious and more costly health problems down the track,” Prof. Rodgers said.

The estimates predate the 60-day prescribing program introduced by the Australian Government in 2023, but given uptake was understood to be slow, patients were yet to see the full benefit of this change, Prof. Rodgers said.  

“Our data highlights a need for further policy interventions to reduce patients’ out-of-pocket expenses.” 

Silent killer: high blood pressure still stalks Australians 

Around 34% of Australian adults are estimated to have high blood pressure but only half of these people are aware they have it, with the lack of widespread screening a major factor.

Of those, 32% have managed to keep their blood pressure in a healthy range, well below similar economies like Canada, where the rate of control is 68%.

Australia’s National Hypertension Taskforce, which is hosting the first National Hypertension Summit in Sydney, has a goal to improve control rates from 32% to 70% by 2030.

“Refocusing on ways to increase detection of high blood pressure, support better management in primary care, and finding better methods to help patients stay on therapy are all needed, but it’s also critical to ensure that the costs are fair and sustainable,” Prof. Rodgers said. 

“Our research sends a clear message to decision makers that we can and must improve health policy to reduce preventable deaths from heart attack, stroke and kidney disease in Australia.”

To estimate expenditure on hypertension diagnosis and treatment by source of funding, researchers used publicly available data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), MedicineInsight general practice reports and Community Pharmacy Agreements.