Generalized cost-effectiveness analysis of pharmaceutical interventions for primary prevention of cardiovascular disease in Thailand

Khonputsa, Panrasri, Veerman, Lennert J., Bertram, Melanie, Lim, Stephen S., Chaiyakunnaphruk, Nathorn and Vos, Theo (2012) Generalized cost-effectiveness analysis of pharmaceutical interventions for primary prevention of cardiovascular disease in Thailand. Value in Health Regional Issues, 1 1: 15-22. doi:10.1016/j.vhri.2012.03.019

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Author Khonputsa, Panrasri
Veerman, Lennert J.
Bertram, Melanie
Lim, Stephen S.
Chaiyakunnaphruk, Nathorn
Vos, Theo
Title Generalized cost-effectiveness analysis of pharmaceutical interventions for primary prevention of cardiovascular disease in Thailand
Journal name Value in Health Regional Issues   Check publisher's open access policy
ISSN 2212-1099
Publication date 2012-05-01
Sub-type Article (original research)
DOI 10.1016/j.vhri.2012.03.019
Volume 1
Issue 1
Start page 15
End page 22
Total pages 8
Place of publication New York, United States
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Objectives: To assess the cost-effectiveness of blood pressure (BP)-lowering and cholesterol-lowering drugs for cardiovascular disease (CVD) prevention.
Methods: We 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.
Results: The 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.
Conclusions: Primary CVD prevention with the polypill or a combination of three generic BP-lowering drugs is very cost-effective in the Thai population.
Keyword Blood pressure–lowering drugs
Cardiovascular disease
Cholesterol-lowering drugs
Cost-effectiveness
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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Created: Thu, 13 Dec 2012, 02:00:07 EST by Geraldine Fitzgerald on behalf of School of Public Health