Key result
A modeled polypill or combination of three generic BP-lowering drugs is very cost-effective for primary CVD prevention in the Thai population, even at modest 10-year risk (5%-9.9%).
Why the study?
Are blood pressure-lowering and cholesterol-lowering drugs, including a polypill, cost-effective for primary prevention of cardiovascular disease in the Thai population compared to doing nothing?
Are blood pressure-lowering and cholesterol-lowering drugs, including a polypill, cost-effective for primary prevention of cardiovascular disease in the Thai population compared to doing nothing?
A polypill or combination of generic BP-lowering drugs is highly cost-effective for primary CVD prevention in Thailand, even for individuals with modest 10-year CVD risk.
May guide Thai primary prevention policies at modest risk; extends modeling data but leaves open prospective validation.
OBJECTIVES: To assess the cost-effectiveness of blood pressure (BP)-lowering and cholesterol-lowering drugs for cardiovascular disease (CVD) prevention. METHODS: We constructed a Markov model in which the Thai population was classified by 10-year absolute CVD risk and modeled the use of BP- and cholesterol-lowering drugs, including a "polypill" (three BP-lowering drugs and a statin). We applied "do-nothing" as the comparator, a health sector perspective on lifetime cost-effectiveness, 3% discounting of costs and effects, and used probabilistic sensitivity analysis. Outcomes are expressed as average and incremental cost-effectiveness in Thai baht per disability-adjusted life-year averted. RESULTS: The polypill would be a very cost-effective option for CVD prevention even in people at modest risk (10-year risk of 5%-9.9%). Use of the three most cost-effective BP drugs is also associated with a net cost saving and large health gain at risk levels greater than 5%. Adding a generic statin gives a price per disability-adjusted life-year of 0.5 (10-year risk at 20%+) to 1.5 (10-year risk at 5%-9.9%) times Thai per-capita gross domestic product using lowest available annual costs. However, at current average drug prices, adding a statin would be considered cost-effective only for those with a 10-year absolute CVD risk of 20% and more. CONCLUSIONS: Primary CVD prevention with the polypill or a combination of three generic BP-lowering drugs is very cost-effective in the Thai population.
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Khonputsa et al. (2012) studied Cardiovascular disease prevention. Blood pressure-lowering and cholesterol-lowering drugs (including a polypill) vs. Do-nothing was evaluated on Average and incremental cost-effectiveness in Thai baht per disability-adjusted life-year averted. A modeled polypill or combination of three generic BP-lowering drugs is very cost-effective for primary CVD prevention in the Thai population, even at modest 10-year risk (5%-9.9%).