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

Overview of attention for article published in Cost Effectiveness and Resource Allocation, August 2016
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Title
Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis
Published in
Cost Effectiveness and Resource Allocation, August 2016
DOI 10.1186/s12962-016-0059-y
Pubmed ID
Authors

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

Abstract

The coverage of prevention and treatment strategies for ischemic heart disease and stroke is very low in Ethiopia. In view of Ethiopia's meager healthcare budget, it is important to identify the most cost-effective interventions for further scale-up. This paper's objective is to assess cost-effectiveness of prevention and treatment of ischemic heart disease (IHD) and stroke in an Ethiopian setting. Fifteen single interventions and sixteen intervention packages were assessed from a healthcare provider perspective. The World Health Organization's Choosing Interventions that are Cost-Effective model for cardiovascular disease was updated with available country-specific inputs, including demography, mortality and price of traded and non-traded goods. Costs and health benefits were discounted at 3 % per year. Incremental cost-effectiveness ratios are reported in US$ per disability adjusted life year (DALY) averted. Sensitivity analysis was undertaken to assess robustness of our results. Combination drug treatment for individuals having >35 % absolute risk of a CVD event in the next 10 years is the most cost-effective intervention. This intervention costs US$67 per DALY averted and about US$7 million annually. Treatment of acute myocardial infarction (AMI) (costing US$1000-US$7530 per DALY averted) and secondary prevention of IHD and stroke (costing US$1060-US$10,340 per DALY averted) become more efficient when delivered in integrated packages. At an annual willingness-to-pay (WTP) level of about US$3 million, a package consisting of aspirin, streptokinase, ACE-inhibitor and beta-blocker for AMI has the highest probability of being most cost-effective, whereas as WTP increases to > US$7 million, combination drug treatment to individuals having >35 % absolute risk stands out as the most cost-effective strategy. Cost-effectiveness ratios were relatively more sensitive to halving the effectiveness estimates as compared with doubling the price of drugs and laboratory tests. In Ethiopia, the escalating burden of CVD and its risk factors warrants timely action. We have demonstrated that selected CVD intervention packages could be scaled up at a modest budget increase. The level of willingness-to-pay has important implications for interventions' probability of being cost-effective. The study provides valuable evidence for setting priorities in an essential healthcare package for CVD in Ethiopia.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 139 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 139 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 30 22%
Researcher 17 12%
Student > Ph. D. Student 12 9%
Student > Bachelor 12 9%
Lecturer 8 6%
Other 18 13%
Unknown 42 30%
Readers by discipline Count As %
Medicine and Dentistry 23 17%
Nursing and Health Professions 20 14%
Pharmacology, Toxicology and Pharmaceutical Science 11 8%
Economics, Econometrics and Finance 8 6%
Social Sciences 6 4%
Other 27 19%
Unknown 44 32%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 August 2016.
All research outputs
#12,902,380
of 22,882,389 outputs
Outputs from Cost Effectiveness and Resource Allocation
#257
of 424 outputs
Outputs of similar age
#181,401
of 355,875 outputs
Outputs of similar age from Cost Effectiveness and Resource Allocation
#2
of 2 outputs
Altmetric has tracked 22,882,389 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 424 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 38th percentile – i.e., 38% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 355,875 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one.