Utilities of Patients with Hypertension in Northern Vietnam

Nguyen, Thi-Phuong-Lan; Krabbe, Paul F M; Nguyen, Thi-Bach-Yen; Schuiling-Veninga, Catharina C M; Wright, E. Pamela; Postma, Maarten J.

doi:10.1371/journal.pone.0139560

Cited by 13 publications

(21 citation statements)

References 27 publications

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“…For example, utility of the general population in Vietnam was 0.88 by EQ-5D measurement [ 32 ]; subsequently applying the weighting scale between EQ-5D and SF-6D [ 33 ] identified utilities in SF-6D at 0.93. Health utility of hypertension was measured by SF-6D in Vietnam, assuming that utility is equal between treated and non-treated patients [ 34 ]. Heath utility of hypertension was also used to weight for MI which was not yet available in Vietnam.…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

et al. 2016

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ObjectiveTo inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD).MethodsA decision tree was combined with a Markov model to measure incremental cost-effectiveness of different approaches to hypertension screening. Values used as input parameters for the model were taken from different sources. Various screening intervals (one-off, annually, biannually) and starting ages to screen (35, 45 or 55 years) and coverage of treatment were analysed. We ran both a ten-year and a lifetime horizon. Input parameters for the models were extracted from local and regional data. Probabilistic sensitivity analysis was used to evaluate parameter uncertainty. A threshold of three times GDP per capita was applied.ResultsCost per quality adjusted life year (QALY) gained varied in different screening scenarios. In a ten-year horizon, the cost-effectiveness of screening for hypertension ranged from cost saving to Int$ 758,695 per QALY gained. For screening of men starting at 55 years, all screening scenarios gave a high probability of being cost-effective. For screening of females starting at 55 years, the probability of favourable cost-effectiveness was 90% with one-off screening. In a lifetime horizon, cost per QALY gained was lower than the threshold of Int$ 15,883 in all screening scenarios among males. Similar results were found in females when starting screening at 55 years. Starting screening in females at 45 years had a high probability of being cost-effective if screening biannually was combined with increasing coverage of treatment by 20% or even if sole biannual screening was considered.ConclusionFrom a health economic perspective, integrating screening for hypertension into routine medical examination and related coverage by health insurance could be recommended. Screening for hypertension has a high probability of being cost-effective in preventing CVD. An adequate screening strategy can best be selected based on age, sex and screening interval.

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Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

et al. 2016

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“…For example, utility of the general population in Vietnam was 0.88 by EQ-5D measurement [32]; subsequently applying the weighting scale between EQ-5D and SF-6D [33] identified utilities in SF-6D at 0.93. Health utility of hypertension was measured by SF-6D in Vietnam, assuming that utility is equal between treated and non-treated patients [34]. Heath utility of hypertension was also used to weight for MI which was not yet available in Vietnam.…”

Section: Health Utilitiesmentioning

confidence: 99%

“…The health utility of stable MI was extracted from a Korean study and weighted for Vietnam, using a ratio of utility for hypertension patients between Korean and Vietnamese [35]. Health utility of stable stroke was extracted from a previous study in Vietnam [34]. Utility for the acute state was weighted from the stable state according to the ratio between acute and stable MI and stroke cited previously [34,36,37].…”

Section: Health Utilitiesmentioning

confidence: 99%

“…Probabilistic sensitivity analysis in 5,000 repetitions of a Monte Carlo simulation examined the uncertainty of input parameters; Table 2 shows input values and distributions. Gamma distributions were applied for costs, beta distributions for [3,34,35] health utilities, lognormal distributions for RRs and beta distributions for transition probabilities. We employed Cholesky decomposition to provide correlated draws, generated from a parameter's multivariate normal distribution for transition probability of hypertension to death and acute CVD [17].…”

Section: Base Case and Sensitivity Analysismentioning

confidence: 99%

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Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

Nguyen

Wright

Nguyen³

et al. 2016

Value in Health

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ObjectiveTo inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD). MethodsA decision tree was combined with a Markov model to measure incremental cost-effectiveness of different approaches to hypertension screening. Values used as input parameters for the model were taken from different sources. Various screening intervals (one-off, annually, biannually) and starting ages to screen (35, 45 or 55 years) and coverage of treatment were analysed. We ran both a ten-year and a lifetime horizon. Input parameters for the models were extracted from local and regional data. Probabilistic sensitivity analysis was used to evaluate parameter uncertainty. A threshold of three times GDP per capita was applied. ResultsCost per quality adjusted life year (QALY) gained varied in different screening scenarios. In a ten-year horizon, the cost-effectiveness of screening for hypertension ranged from cost saving to Int$ 758,695 per QALY gained. For screening of men starting at 55 years, all screening scenarios gave a high probability of being cost-effective. For screening of females starting at 55 years, the probability of favourable cost-effectiveness was 90% with one-off screening. In a lifetime horizon, cost per QALY gained was lower than the threshold of Int$ 15,883 in all screening scenarios among males. Similar results were found in females when starting screening at 55 years. Starting screening in females at 45 years had a high PLOS ONE |

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“…The long-term stroke utility values were sourced from a UK disease-speci c population study of the quality of life of patients post-stroke [47]. The quality of life of patients in the post-IHD health state was calculated using a Vietnamese population speci c odds ratio comparing the utility of patients with and without history of previous cerebrovascular event [46], which has previously been used as a proxy for the long-term quality of life in patients with stable cardiovascular disease [42].…”

Section: Quality Of Lifementioning

confidence: 99%

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Taylor¹,

Hoek²,

Deltetto

et al. 2020

Preprint

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Background Dietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.Methods The three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy. Results The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and IHD events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (-3,445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (-43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (-243,530 ₫ US$ -10.49; 0.074 QALYs gained). Conclusion This research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment, however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered.

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Utilities of Patients with Hypertension in Northern Vietnam

Cited by 13 publications

References 27 publications

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

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