Journal
HEALTH POLICY AND PLANNING
Volume 26, Issue 3, Pages 210-222Publisher
OXFORD UNIV PRESS
DOI: 10.1093/heapol/czq045
Keywords
Cost-effectiveness; cardiovascular disease; systolic blood pressure; cholesterol; salt intake; Vietnam
Funding
- Vietnam Education Foundation (VEF)
- Jiaikai Foundation
- Atlantic Philanthropies
- Vietnam Health Strategy and Policy Institute
- School of Population Health at the University of Queensland
- Non-Communicable Disease Program
- National Heart Institute
- Department of Health System and Financing
- WHO-Geneva
- WHO office in Hanoi
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Objectives To assess the costs, health effects and cost-effectiveness of a set of personal and non-personal prevention strategies to reduce CVD in Vietnam, including mass media campaigns for reducing consumption of salt and tobacco, drugs for lowering blood pressure or cholesterol, and combined pharmacotherapy for people at varying levels of absolute risk of a cardiovascular event. Methods WHO-CHOICE methods and analytical models were employed, using local data to estimate the costs, effects and cost-effectiveness of 12 population and individual interventions implemented singly or in combination. Costs were measured in Vietnamese Dong for the year 2007 (discounted at a rate of 3% per year), while health effects were expressed in age-weighted and discounted disability-adjusted life years (DALYs) averted. Results A health education programme to reduce salt intake (VND 1 945 002 or US$118 per DALY averted) and individual treatment of systolic blood pressure above 160 mmHg (VND 1 281 596 or US$78 per DALY averted) were found to be the most cost-effective measures for population- and individual-based approaches, respectively. Where budget is very limited, a mass media education programme on salt intake and a combination mass media programme addressing salt intake, cholesterol and tobacco should be selected first. If more resources become available, greatest population health gains can be achieved via individual treatment of systolic blood pressure and the absolute risk approach to CVD prevention. Conclusions Contextualization of WHO-CHOICE using local data provides health decision-makers with more sound economic evidence for policy debates on prioritizing health interventions to reduce cardiovascular diseases in Vietnam. When used, cost-effectiveness analysis could increase efficiency in allocating scare resources.
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