Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis

Tolla, Mieraf Taddesse; Norheim, Ole Frithjof; Memirie, Solomon Tessema; Abdisa, Senbeta Guteta; Ababulgu, Awel; Jerene, Degu; Bertram, Melanie; Strand, Kirsten; Verguet, Stéphane; Johansson, Kjell Arne

doi:10.1186/s12962-016-0059-y

Cost Effectiveness and Resource Allocation

Table 5 Average cost-effectiveness ratios for cardiovascular disease interventions under multiple scenarios

From: Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis

Intervention description	Base-case	Undiscounted health benefits^a	10 % coverage^b	Double cost^c	Lower effect^d	50 % effect^e
Acute myocardial infarction
ACE-inhibitor	7526	5626	14,718	7777	26,556	15,172
Beta-blocker	4054	3031	7926	4191	26,556	8171
ASA	2398	1792	4685	2480	3545	4831
Streptokinase	2407	1799	4343	2855	3714	4850
ASA + clopidogrel	1652	1235	3225	1712	2958	3327
ASA + streptokinase	1345	1006	2419	1603	2015	2669
ASA + streptokinase + ACE-inhibitor	1188	888	2133	1411	1903	2342
Primary PCI	3013	2252	4560	4460	4833	5983
ASA + streptokinase + ACE-inhibitor + beta-blocker	998	746	1774	1210	1839	1950
ASA + clopidogrel + PCI	2112	1579	3171	2240	3410	4062
Acute stroke
ASA	39,896	31,586	75,658	42,135	99,269	79,449
Post-acute myocardial infarction
ASA	10,345	7701	19,853	11,173	50,593	19,029
Statin	8822	6552	16,139	10,119	10,659	11,594
Beta-blocker	5177	3844	9823	5575	7386	10,296
ACE-inhibitor	4856	3612	9182	5264	6092	6771
ASA + beta-blocker	3512	2610	6612	3835	6556	6793
ASA + beta-blocker + statin	2717	2018	4904	3182	4351	4597
ASA + beta-blocker + statin + ACE-inhibitor	1849	1373	3349	2197	2704	2908
Post-acute stroke
ACE-inhibitor	3152	2394	5642	3663	3153	3153
ASA	2822	2121	5065	3264	9996	4833
Statin	2397	1820	4046	3042	3427	4355
ASA + statin	1429	1080	2382	1844	2730	2528
ASA + statin + ACE-inhibitor	1061	803	1751	1386	1616	1545
Primary prevention of IHD and stroke
Cholesterol lowering treatment for total chol. >6.2 mmol/l	532	293	791	738	605	941
Cholesterol lowering treatment for total chol. >5.7 mmol/l	557	311	676	888	636	1002
Anti-hypertension treatment for SBP >160 mmHg	74	42	97	102	77	124
Combination drug treatment for absolute risk of CVD >35 %	67	39	88	103	69	94
Anti-hypertension treatment for SBP >140 mmHg	154	88	172	234	161	263
Combination drug treatment for absolute risk of CVD >25 %	77	45	95	124	80	108
Combination drug treatment for absolute risk of CVD >15 %	94	55	108	157	98	132
Combination drug treatment for absolute risk of CVD >5 %	141	82	153	245	148	199

^aUndiscounted health benefits
^b10 % target coverage
^cDouble price for drugs, procedures and laboratory test
^dLower boundary of effectiveness estimate
^e50 % of point estimate of effectiveness

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ISSN: 1478-7547

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