Hospitalization costs associated with as-needed blood pressure medication use in the Veterans Healthcare System.

As-needed blood pressure (BP) medication used to treat asymptomatic BP elevations in the hospital may be harmful. However, its association with hospitalization costs remains unknown. We conducted a retrospective cohort study with target trial emulation and propensity-score matching to compare the total and subtype hospitalization costs for those who received as-needed BP medication (YES) versus not (NO) during a Veterans Affairs hospital stay between October 1, 2015 and September 30, 2020. After matching (n = 25,455 per group), the as-needed YES group had a longer length of stay compared to the NO group. Hospitalizations in the YES group were associated with higher total and subtype hospitalization costs compared to the NO group. Similarly, individuals in the YES group had higher daily total hospital costs compared to the NO group, driven primarily by increased nursing and surgery costs. Our findings suggest that the expenditure implications of as-needed BP medication use merit further investigation.