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dc.contributor.authorTolla, Mieraf Taddesseen_US
dc.contributor.authorNorheim, Ole Frithjofen_US
dc.contributor.authorMemirie, Solomon Tessemaen_US
dc.contributor.authorAbdisa, Senbeta Gutetaen_US
dc.contributor.authorAbabulgu, Awelen_US
dc.contributor.authorJerene, Deguen_US
dc.contributor.authorBertram, Melanieen_US
dc.contributor.authorStrand, Kirstenen_US
dc.contributor.authorVerguet, Stéphaneen_US
dc.contributor.authorJohansson, Kjell Arneen_US
dc.PublishedCost Effectiveness and Resource Allocation 2016, 14:10eng
dc.description.abstractBackground: The coverage of prevention and treatment strategies for ischemic heart disease and stroke is very low in Ethiopia. In view of Ethiopia’s meager healthcare budget, it is important to identify the most cost-effective interventions for further scale-up. This paper’s objective is to assess cost-effectiveness of prevention and treatment of ischemic heart disease (IHD) and stroke in an Ethiopian setting. Methods: Fifteen single interventions and sixteen intervention packages were assessed from a healthcare provider perspective. The World Health Organization’s Choosing Interventions that are Cost-Effective model for cardiovascular disease was updated with available country-specific inputs, including demography, mortality and price of traded and non-traded goods. Costs and health benefits were discounted at 3 % per year. Incremental cost-effectiveness ratios are reported in USD per disability adjusted life year (DALY) averted. Sensitivity analysis was undertaken to assess robustness of our results. Results: Combination drug treatment for individuals having >35 % absolute risk of a CVD event in the next 10 years is the most cost-effective intervention. This intervention costs USD 67 per DALY averted and about USD 7 million annually. Treatment of acute myocardial infarction (AMI) (costing USD 1000–USD 7530 per DALY averted) and secondary prevention of IHD and stroke (costing USD 1060–USD 10,340 per DALY averted) become more efficient when delivered in integrated packages. At an annual willingness-to-pay (WTP) level of about USD 3 million, a package consisting of aspirin, streptokinase, ACE-inhibitor and beta-blocker for AMI has the highest probability of being most cost-effective, whereas as WTP increases to > USD 7 million, combination drug treatment to individuals having >35 % absolute risk stands out as the most cost-effective strategy. Cost-effectiveness ratios were relatively more sensitive to halving the effectiveness estimates as compared with doubling the price of drugs and laboratory tests. Conclusions: In Ethiopia, the escalating burden of CVD and its risk factors warrants timely action. We have demonstrated that selected CVD intervention packages could be scaled up at a modest budget increase. The level of willingness-to-pay has important implications for interventions’ probability of being cost-effective. The study provides valuable evidence for setting priorities in an essential healthcare package for CVD in Ethiopia.en_US
dc.publisherBioMed Centraleng
dc.relation.ispartof<a href="" target="_blank">Prevention and treatment of cardiovascular disease in Ethiopia saves more than lives: cost-effectiveness analysis, extended cost-effectiveness analysis, and financial risk protection</a>
dc.rightsAttribution CC BYeng
dc.subjectCost-effectiveness analysiseng
dc.subjectCardiovascular diseaseeng
dc.subjectIschemic heart diseaseeng
dc.titlePrevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysisen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright The Author(s)

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