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Table 6 Intervention effects, costs, disability weights and other transition probabilities

From: Cost-effectiveness of medical primary prevention strategies to reduce absolute risk of cardiovascular disease in Tanzania: a Markov modelling study

Parameter

Model input§ (95 % CI)

Source

a. Intervention effects and costs

     

 Angiotensin converting enzyme inhibitor

     

  RR1

MI2

0.81(0.70 - 0.94)

  

[58]

 

Stroke

0.65(0.52 - 0.82)

   

  Cost3

 

14.10

  

[59]

 Angiotensin receptor blocker

     

  RR

MI

0.94 (0.85 - 1.03)

  

[60]

 

Stroke

0.91(0.85 - 0.98)

   

  Cost

 

64.83

  

[59]

 Beta-blocker

     

  RR

MI

0.90 (0.78 - 1.03)

  

[58]

 

Stroke

0.83 (0.72 - 0.97)

   

  Cost

 

6.82

  

[59]

 Biguanide

     

  RR

MI

0.67 (0.51 - 0.89)

  

[61]

 

Stroke

0.80 (0.50 - 1.27)

   

  Cost

 

21.15

  

[59]

 Calcium channel blocker

     

  RR

MI

0.85 (0.78 - 0.92)

  

[62]

 

Stroke

0.66 (0.58 - 0.75)

   

  Cost

 

13.19

  

[59]

 Soluble Aspirin

     

  RR

MI

0.77 (0.69 - 0.86)

  

[63]

 

Stroke

0.95 (0.85 - 1.06)

   

  Cost

 

14.79

  

[59]

 Statin

     

  RR

MI

0.86 (0.82 - 0.90)

  

[64]

 

Stroke

0.90 (0.85 - 0.95)

   

  Cost

 

15.92

  

[59]

 Sulfonylureas

     

  RR

MI

0.85 (0.74 - 0.97)

  

[61]

 

Stroke

0.91 (0.73 - 1.13)

   

  Cost

 

6.37

  

[59]

 Thiazide diuretics

     

  RR

MI

0.84 (0.75 - 0.95)

  

[58]

 

Stroke

0.63 (0.57 - 0.71)

   

  Cost

 

1.18

  

[59]

b. Costs

     

 Cost of CVD4 prevention

     

  Patient cost per OPD5 visit

 

15.1

  

[34]¶

  Provider cost per OPD visit

 

7.15

   

  Provider cost per lab test

 

4.07

   

 Cost of CVD treatment

     

  Patient cost per CVD treatment

 

194

  

[35]

 

MI

Mild stroke

Mod.6 stroke

Sev.7 stroke

 

 CVD risk - first year

310

271

512

570

Estimation

 CVD risk - subsequent years

260

67

76

313

 

 CVD risk with diabetes - first year

358

319

560

594

 

 CVD risk with diabetes - subsequent years

308

115

124

361

 

c. Disability weights8

     

 Acute MI

 

0.42 (0.28 - 0.57)

  

[26]

 Mild stroke

 

0.02 (0.01 - 0.04)

   

 Moderate stroke

 

0.08 (0.05 - 0.11)

   

 Severe stroke

 

0.54 (0.36 - 0.71)

   

d. Other probabilities

     

 In the event of a first ever stroke,

     

 what is the probability of a:

     

  mild stroke for a CVD risk

 

0.19

  

[65, 66]

  moderate for a CVD risk

 

0.44

  

Extrapolation

  severe for a CVD risk

 

0.27

  

and

  mild stroke for a CVD risk with diabetes

 

0.15

  

assumptions

  moderate for a CVD risk with diabetes

 

0.35

   

  severe for a CVD risk with diabetes

 

0.50

   

 In the event of a subsequent stroke,

     

 what is the probability of:

     

  …mild stroke

 

0.15

   

  …moderate stroke

 

0.25

   

  …severe stroke

 

0.60

   
  1. 1RR - Relative risk with beta distribution fitted; 2MI - Myocardial in arction; 3Cost - All costs are in 2012 US$ and were fitted with a gamma distribution; 4CVD - Cardiovascular disease; 5OPD - Out-patient department; 6Mod. - Moderate; 7Sev. - Severe; 8Beta distribution was fitted disability weights and other probabilities; §All model parameters were varied at ± 15 % unless stated; ¶ provider cost per OPD visit is the average cost per visit for the four facilities costed, provider cost per lab test available from Table 5, Patient cost per OPD visit was derived from annual patient cost divided by average number of clinic visits [34].
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BMC Health Services Research

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