Cardiovascular disease prevention with a multidrug regimen in the developing world: a cost-effectiveness analysis.

摘要: Summary Background Cardiovascular disease is the leading cause of death, with 80% cases occurring in developing countries. We therefore aimed to establish whether use evidence-based multidrug regimens for patients at high risk cardiovascular would be cost-effective low-income and middle-income Methods used a Markov model do cost-effectiveness analysis two combination regimens. For primary prevention, we aspirin, calcium-channel blocker, an angiotensin-converting-enzyme inhibitor, statin, assessed them four groups different thresholds absolute risks disease. secondary same drugs one group, but substituted β blocker blocker. To compare strategies, report incremental ratios (ICER), US$ per quality-adjusted life-year (QALY). Findings recorded that preventive strategies could result 2-year gain life expectancy. Across six World Bank regions, prevention yielded ICERs US$746–890/QALY gained 10-year greater than 25%, $1039–1221/QALY those 5%. ranged from $306/QALY $388/QALY gained. Interpretation Regimens blood-pressure drugs, statin halve death high-risk patients. This approach according WHO recommendations, robust across several estimates drug efficacy treatment cost. Developing countries should encourage these inexpensive are currently available both prevention.