The cost-effectiveness of hypertension management in low-income and middle-income countries: a review
Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/9/e002213.full |
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| author | Kunihiro Matsushita Andrew E Moran Rachel Nugent Laura K Cobb Deliana Kostova Garrison Spencer Muhammad Jami Husain Biplab Kumar Datta |
| author_facet | Kunihiro Matsushita Andrew E Moran Rachel Nugent Laura K Cobb Deliana Kostova Garrison Spencer Muhammad Jami Husain Biplab Kumar Datta |
| author_sort | Kunihiro Matsushita |
| collection | DOAJ |
| description | Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes. |
| format | Article |
| id | doaj-art-8f21ca8cc9744d09a0c8d4fe072bcd4a |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-8f21ca8cc9744d09a0c8d4fe072bcd4a2025-08-20T02:21:06ZengBMJ Publishing GroupBMJ Global Health2059-79082020-09-015910.1136/bmjgh-2019-002213The cost-effectiveness of hypertension management in low-income and middle-income countries: a reviewKunihiro Matsushita0Andrew E Moran1Rachel Nugent2Laura K Cobb3Deliana Kostova4Garrison Spencer5Muhammad Jami Husain6Biplab Kumar Datta7Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USAResolve to Saves Lives, New York, New York, USARTI International, Seattle, Washington, USAResolve to Save Lives, New York, New York, USADivision of Global Health Protection, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA1 RTI International, Research Triangle Park, North Carolina, USADivision of Global Health Protection, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USAInstitute of Public and Preventive Health, Augusta University, Augusta, Georgia, USAHypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.https://gh.bmj.com/content/5/9/e002213.full |
| spellingShingle | Kunihiro Matsushita Andrew E Moran Rachel Nugent Laura K Cobb Deliana Kostova Garrison Spencer Muhammad Jami Husain Biplab Kumar Datta The cost-effectiveness of hypertension management in low-income and middle-income countries: a review BMJ Global Health |
| title | The cost-effectiveness of hypertension management in low-income and middle-income countries: a review |
| title_full | The cost-effectiveness of hypertension management in low-income and middle-income countries: a review |
| title_fullStr | The cost-effectiveness of hypertension management in low-income and middle-income countries: a review |
| title_full_unstemmed | The cost-effectiveness of hypertension management in low-income and middle-income countries: a review |
| title_short | The cost-effectiveness of hypertension management in low-income and middle-income countries: a review |
| title_sort | cost effectiveness of hypertension management in low income and middle income countries a review |
| url | https://gh.bmj.com/content/5/9/e002213.full |
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