Table 2

Summary of studies included
Authors, year and title Setting Intervention/s Main economic findings (outcome metric) Target population Quality score (Drummond) In overall summary (Figure 2)
Huang Guangyong et al., 2000 [45] Cost effectiveness of the Beijing Fangshan cardiovascular prevention programme China Health education and anti-hypertensive drugs Intervention found to be cost effective Initially whole population, then high risk +/− No –limited comparability
Gaziano et al., 2007 [18] Cardiovascular disease prevention with a multidrug regimen in the developing world 6 World Bank Regions Fixed dose combination therapy Found cost effective in all world regions for primary and secondary prevention Various + + Yes
Caro et al. 1999 [25] International economic analysis of primary prevention of cardiovascular disease with Pravastatin in WOSCOPS South Africa Pravastatin for primary prevention Authors describe Pravastatin as efficient for CVD primary prevention. Note, cost per LYG close to 3 X GNI per capita for study year. Thus cost/DALY likely to be > 3 X GNI/Capita Men with high cholesterol + Yes
Rubinstein et al., 2009 [17] Generalised cost effectiveness analysis of a package of interventions to reduce cardiovascular disease in Buenos Aires, Argentina Argentina Personal pharmacological and non personal population-based interventions All interventions cost effective with exception of statins to lower “high” cholesterol Various + + Yes
Anh Ha and Chisholm, 2010 [24] Cost effectiveness of intervention to prevent cardiovascular disease in Vietnam Vietnam Personal pharmacological and non personal population-based interventions. Range of interventions judged cost effective and deliverable at low cost Various + + Yes
Gaziano et al., 2005 [30]. Cost effectiveness analysis of hypertension guidelines in South Africa South Africa Antihypertensive drugs Absolute risk based initiation of therapy dominated a strategy of initiating medications based on blood pressure threshold alone Hypertensive/high CVD risk. + + Yes
Schuffham et al., 2006 [47]. The cost effectiveness of Fluvastatin in Hungary Following Successful PCI Hungary statins Judged to be cost effective Post PCI patients +/− No-limited generalisability
Gilbert et al., 2004 [34]. The cost effectiveness of pharmacological smoking cessation therapies in developing countries Seychelles Smoking cessation Shown to be cost effective but affordability in LMIC settings questioned given high cost Smokers + Yes
Robberstad et al., 2007 [20]. Cost effectiveness of medical interventions to prevent cardiovascular disease in a Sub-Saharan African country Tanzania Pharmaco-prevention including the polypill Some interventions judged cost effective but affordability in this setting questioned Those over age 45 + Yes
Redekop et al., 2008 [46]. Costs and effects of secondary prevention with Perindopril in Stable Coronary Heart Disease in Poland Poland ACE inhibitos for secondary prevention Authors report high probability for Perindopril effectiveness in secondary prevention. Using reported results against WHO criteria we find not cost effective – not study conclusions Those with existing CHD +/- Yes
Thavorn et al., 2007 [36]. A cost effectiveness analysis of a community pharmacist-based smoking cessation programme in Thailand Thailand Nicotine replacement therapy Authors find intervention to be cost saving. (cost/LYG) Regular smokers + Yes
Araujo et al., 2007 [48]. Cost effectiveness and budget impact analysis of Rosuvastatin and Atorvastatin for LDL cholesterol and cardiovascular events lowering within the SUS scenario Brazil Branded statin Rosuvasctatin found to be more cost effective than Atorvastatin Those at high risk of CVD - No-comparison of 2 drugs of same class
Akkazieva et al., 2009 [15]. The health effects and costs of the interventions to control cardiovascular disease in Kyrgyzstan Kyrgyzstan Pharmacological and non personal population-based interventions Wide range of cost effectiveness between interventions. Blood pressure lowering drugs and mass media most cost effective Variable + + Yes
Murray et al., 2003 [23]. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol 6 world bank regions Pharmacological and non personal population-based interventions Non personal interventions found to be most cost effective. Absolute risk based approach also found to be cost effective Various ++ Yes
Disease Control Priorities Project * [32,49] Chapters 44: Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. 45: Blood Pressure, Cholesterol and Bodyweight, 46: Tobacco Addiction. 6 world bank regions Pharmacological and non personal population-based interventions. Tobacco control interventions, salt reduction and multidrug therapy on the basis of absolute risk approach likely to be cost effective in most settings. Various ++ Yes
WHO + Chisholm *[5,12] Comparative cost effectiveness of policy instruments for reducing the global burden of alcohol, tobacco and illicit drug use. WHO regions Personal and non personal interventions for tobacco control Most interventions cost effective, non personal interventions such as taxation and legislation far more so than personal interventions such as NRT. Smokers ++ Yes

Abbreviations: CHD: Coronary Heart Disease. CVD: Cardiovascular Disease. GNI: Gross National Income. GDP: Gross Domestic Product. DALY: Disability Adjusted Life Year. QALY: Quality Adjusted Life Year. YLG: Year of Life Gained. NRT: Nicotine Replacement Therapy. LMIC: Low and Middle Income. ACE: Angiotensin-Converting Enzyme. LDL: Low Density Lipoprotein. PCI: Percutaneous Coronary intervention. * Material concerning analysis presented in more than one journal article.

Shroufi et al.

Shroufi et al. BMC Public Health 2013 13:285   doi:10.1186/1471-2458-13-285

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