Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context
Summary: Background: Cardiovascular diseases (CVD) remains a leading cause of mortality in Myanmar. Despite the burden, CVD preventive services receive low government and donor budgets, which has led to poor CVD outcomes. Methods: We conducted a cost-effective analysis and a budget impact analysis...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-07-01
|
| Series: | The Lancet Regional Health - Southeast Asia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772368224000441 |
| _version_ | 1827287866754990080 |
|---|---|
| author | Zin Mar Win Wenhui Mao Tom Traill Zarni Lynn Kyaw Pyone Yadanar Paing Osondu Ogbuoji Gavin Yamey |
| author_facet | Zin Mar Win Wenhui Mao Tom Traill Zarni Lynn Kyaw Pyone Yadanar Paing Osondu Ogbuoji Gavin Yamey |
| author_sort | Zin Mar Win |
| collection | DOAJ |
| description | Summary: Background: Cardiovascular diseases (CVD) remains a leading cause of mortality in Myanmar. Despite the burden, CVD preventive services receive low government and donor budgets, which has led to poor CVD outcomes. Methods: We conducted a cost-effective analysis and a budget impact analysis on CVD prevention strategies recommended by the WHO. A Markov model was used to analyse the cost and quality-adjusted life year (QALY) from healthcare provider and societal perspectives. We calculated transition probabilities from WHO CVD risk data and obtained treatment effects and costs from secondary sources. Subgroup analysis was performed on different sex and age groups. We framed the budget impact analysis from a healthcare provider perspective to assess the affordability of providing CVD preventive care. Findings: The most cost-effective strategy from the healthcare provider perspective varied. The combination of screening, primary prevention, and secondary prevention (Sc-PP-SP) (incremental cost-effectiveness ratio [ICER]: US$1574/QALY) is most cost-effective at the three times gross domestic product (GDP) per capita threshold, while at one time the GDP per capita threshold, secondary prevention is the most cost-effective strategy (ICER: US$160/QALY). Sc-PP-SP is the most cost-effective strategy from the societal perspective (ICER: US$647/QALY). Among age groups, intervention at age 45 years appeared to be the most cost-effective option for both men and women. The budget impact revealed the Sc-PP-SP would avert 55,000 acute CVD events and 28,000 CVD-related deaths with a cost of US$157 million for the first year of CVD preventive care. Interpretation: A combination of screening, primary prevention, and secondary prevention is cost-effective to reduce CVD-related deaths in Myanmar. This study provides evidence for the government and development partners to increase investment in and support for CVD prevention. These findings not only provide a basis for efficient resource allocation but also underscore the importance of adopting a total cardiovascular risk approach to CVD prevention, in alignment with global health goals. Funding: Pilot grant from Duke Global Health Institute, USA. |
| first_indexed | 2024-04-24T11:20:18Z |
| format | Article |
| id | doaj.art-768a165ed3ae4215b063b158bb8a4388 |
| institution | Directory Open Access Journal |
| issn | 2772-3682 |
| language | English |
| last_indexed | 2024-04-24T11:20:18Z |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health - Southeast Asia |
| spelling | doaj.art-768a165ed3ae4215b063b158bb8a43882024-04-11T04:42:11ZengElsevierThe Lancet Regional Health - Southeast Asia2772-36822024-07-0126100394Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in contextZin Mar Win0Wenhui Mao1Tom Traill2Zarni Lynn Kyaw3Pyone Yadanar Paing4Osondu Ogbuoji5Gavin Yamey6Community Partners International (CPI), Yangon, MyanmarCentre for Policy Impact in Global Health, Duke University, Durham, NC 27708, USA; Duke Global Health Institute, Duke University, Durham, NC 27708, USA; Corresponding author. Centre for Policy Impact in Global Health, Duke University, Durham, NC 27708, USA.Community Partners International (CPI), Yangon, MyanmarCommunity Partners International (CPI), Yangon, MyanmarCommunity Partners International (CPI), Yangon, MyanmarCentre for Policy Impact in Global Health, Duke University, Durham, NC 27708, USA; Duke Global Health Institute, Duke University, Durham, NC 27708, USACentre for Policy Impact in Global Health, Duke University, Durham, NC 27708, USA; Duke Global Health Institute, Duke University, Durham, NC 27708, USASummary: Background: Cardiovascular diseases (CVD) remains a leading cause of mortality in Myanmar. Despite the burden, CVD preventive services receive low government and donor budgets, which has led to poor CVD outcomes. Methods: We conducted a cost-effective analysis and a budget impact analysis on CVD prevention strategies recommended by the WHO. A Markov model was used to analyse the cost and quality-adjusted life year (QALY) from healthcare provider and societal perspectives. We calculated transition probabilities from WHO CVD risk data and obtained treatment effects and costs from secondary sources. Subgroup analysis was performed on different sex and age groups. We framed the budget impact analysis from a healthcare provider perspective to assess the affordability of providing CVD preventive care. Findings: The most cost-effective strategy from the healthcare provider perspective varied. The combination of screening, primary prevention, and secondary prevention (Sc-PP-SP) (incremental cost-effectiveness ratio [ICER]: US$1574/QALY) is most cost-effective at the three times gross domestic product (GDP) per capita threshold, while at one time the GDP per capita threshold, secondary prevention is the most cost-effective strategy (ICER: US$160/QALY). Sc-PP-SP is the most cost-effective strategy from the societal perspective (ICER: US$647/QALY). Among age groups, intervention at age 45 years appeared to be the most cost-effective option for both men and women. The budget impact revealed the Sc-PP-SP would avert 55,000 acute CVD events and 28,000 CVD-related deaths with a cost of US$157 million for the first year of CVD preventive care. Interpretation: A combination of screening, primary prevention, and secondary prevention is cost-effective to reduce CVD-related deaths in Myanmar. This study provides evidence for the government and development partners to increase investment in and support for CVD prevention. These findings not only provide a basis for efficient resource allocation but also underscore the importance of adopting a total cardiovascular risk approach to CVD prevention, in alignment with global health goals. Funding: Pilot grant from Duke Global Health Institute, USA.http://www.sciencedirect.com/science/article/pii/S2772368224000441Cost-effectiveness analysisIncremental cost-effectiveness ratioBudget impact analysisCardiovascular diseaseMarkov modelMyanmar |
| spellingShingle | Zin Mar Win Wenhui Mao Tom Traill Zarni Lynn Kyaw Pyone Yadanar Paing Osondu Ogbuoji Gavin Yamey Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context The Lancet Regional Health - Southeast Asia Cost-effectiveness analysis Incremental cost-effectiveness ratio Budget impact analysis Cardiovascular disease Markov model Myanmar |
| title | Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context |
| title_full | Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context |
| title_fullStr | Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context |
| title_full_unstemmed | Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context |
| title_short | Cost-effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in Myanmar: an economic modelling studyResearch in context |
| title_sort | cost effectiveness and budget impact analysis of screening and preventive interventions for cardiovascular disease in myanmar an economic modelling studyresearch in context |
| topic | Cost-effectiveness analysis Incremental cost-effectiveness ratio Budget impact analysis Cardiovascular disease Markov model Myanmar |
| url | http://www.sciencedirect.com/science/article/pii/S2772368224000441 |
| work_keys_str_mv | AT zinmarwin costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT wenhuimao costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT tomtraill costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT zarnilynnkyaw costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT pyoneyadanarpaing costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT osonduogbuoji costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext AT gavinyamey costeffectivenessandbudgetimpactanalysisofscreeningandpreventiveinterventionsforcardiovasculardiseaseinmyanmaraneconomicmodellingstudyresearchincontext |