Implications of scaling up cardiovascular disease treatment in South Africa: a microsimulation and cost-effectiveness analysis

Publication date: Available online 6 December 2018Source: The Lancet Global HealthAuthor(s): Sanjay Basu, Ryan G Wagner, Ronel Sewpaul, Priscilla Reddy, Justine DaviesSummaryBackgroundCardiovascular diseases and their risk factors—particularly hypertension, dyslipidaemia, and diabetes—have become an increasing concern for middle-income countries. Using newly available, nationally representative data, we assessed how cardiovascular risk factors are distributed across subpopulations within South Africa and identified which cardiovascular treatments should be prioritised.MethodsWe created a demographically representative simulated population for South Africa and used data from 17 743 respondents aged 15 years or older of the 2012 South African National Health and Nutrition Examination Survey (SANHANES) to assign information on cardiovascular risk factors to each member of the simulated population. We created a microsimulation model to estimate the health and economic implications of two globally recognised treatment recommendations: WHO's package of essential non-communicable disease interventions (PEN) and South Africa's Primary Care 101 (SA PC 101) guidelines. The primary outcome was total disability-adjusted life-years (DALYs) averted through treatment of all cardiovascular disease or microvascular type 2 diabetes complications per 1000 population. We compared outcomes at the aspirational level of achieving access to treatment among 70% of the population.FindingsBased o...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research