Generalized Cost-Effectiveness Analysis of Pharmaceutical Interventions for Primary Prevention of Cardiovascular Disease in Thailand
| Autor: | Stephen S Lim, Theo Vos, Nathorn Chaiyakunnaphruk, Panrasri Khonputsa, Melanie Y Bertram, Lennert J. Veerman |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Statin Cost effectiveness medicine.drug_class Economics Econometrics and Finance (miscellaneous) Psychological intervention Disease 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine cardiovascular disease Primary prevention Environmental health Medicine 030212 general & internal medicine blood pressure–lowering drugs Polypill Pharmacology Toxicology and Pharmaceutics (miscellaneous) cost-effectiveness health care economics and organizations Preventive healthcare business.industry Health Policy Cost-effectiveness analysis Thailand cholesterol-lowering drugs 3. Good health business |
| Zdroj: | Value in health regional issues. 1(1) |
| ISSN: | 2212-1102 |
| Popis: | ObjectivesTo assess the cost-effectiveness of blood pressure (BP)-lowering and cholesterol-lowering drugs for cardiovascular disease (CVD) prevention.MethodsWe constructed a Markov model in which the Thai population was classified by 10-year absolute CVD risk and modeled the use of BP- and cholesterol-lowering drugs, including a “polypill” (three BP-lowering drugs and a statin). We applied “do-nothing” as the comparator, a health sector perspective on lifetime cost-effectiveness, 3% discounting of costs and effects, and used probabilistic sensitivity analysis. Outcomes are expressed as average and incremental cost-effectiveness in Thai baht per disability-adjusted life-year averted.ResultsThe polypill would be a very cost-effective option for CVD prevention even in people at modest risk (10-year risk of 5%–9.9%). Use of the three most cost-effective BP drugs is also associated with a net cost saving and large health gain at risk levels greater than 5%. Adding a generic statin gives a price per disability-adjusted life-year of 0.5 (10-year risk at 20%+) to 1.5 (10-year risk at 5%–9.9%) times Thai per-capita gross domestic product using lowest available annual costs. However, at current average drug prices, adding a statin would be considered cost-effective only for those with a 10-year absolute CVD risk of 20% and more.ConclusionsPrimary CVD prevention with the polypill or a combination of three generic BP-lowering drugs is very cost-effective in the Thai population. |
| Databáze: | OpenAIRE |
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