Evidence map›Paper›PMID 26555122›Full record

ArticleCirculation. Cardiovascular quality and outcomes2015

Health and Economic Implications of National Treatment Coverage for Cardiovascular Disease in India: Cost-Effectiveness Analysis.

Sanjay Basu, Eran Bendavid, Neeraj Sood

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  14. Cardiovascular Diseases in India Compared With the United States.Journal of the American College of Cardiology · 2018
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Sanjay BasuFrom the Department of Medicine Prevention Research Center, Center for Primary Care and Outcomes Research, (S.B., E.B.), Department of Medicine Stanford Institute for Economic Policy Research, Prevention Research Center (S.B.), and Division of General Medical Disciplines (E.B.), Stanford University, Stanford, CA; Department of Economics National Bureau of Economic Research, Center for International Development, Stanford Institute for Economic Policy Research, Stanford, CA (S.B.); Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom (S.B.); Department of Pharmaceutical Economics and Policy and Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles (N.S.); and National Bureau of Economic Research, Cambridge, MA (N.S.). basus@stanford.edu.
Eran BendavidFrom the Department of Medicine Prevention Research Center, Center for Primary Care and Outcomes Research, (S.B., E.B.), Department of Medicine Stanford Institute for Economic Policy Research, Prevention Research Center (S.B.), and Division of General Medical Disciplines (E.B.), Stanford University, Stanford, CA; Department of Economics National Bureau of Economic Research, Center for International Development, Stanford Institute for Economic Policy Research, Stanford, CA (S.B.); Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom (S.B.); Department of Pharmaceutical Economics and Policy and Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles (N.S.); and National Bureau of Economic Research, Cambridge, MA (N.S.).
Neeraj SoodFrom the Department of Medicine Prevention Research Center, Center for Primary Care and Outcomes Research, (S.B., E.B.), Department of Medicine Stanford Institute for Economic Policy Research, Prevention Research Center (S.B.), and Division of General Medical Disciplines (E.B.), Stanford University, Stanford, CA; Department of Economics National Bureau of Economic Research, Center for International Development, Stanford Institute for Economic Policy Research, Stanford, CA (S.B.); Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom (S.B.); Department of Pharmaceutical Economics and Policy and Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles (N.S.); and National Bureau of Economic Research, Cambridge, MA (N.S.).

Funding

CORE--PROGRAM DEVELOPMENTP30AG017253 · NIA · STANFORD UNIVERSITY · PI BHATTACHARYA, JAY · 1999 to 2019
$5.8M
Cohort filtering models to identify social program effects on health disparitiesDP2MD010478 · NIMHD · STANFORD UNIVERSITY · PI BASU, SANJAY · 2015 to 2015
$2.4M
Studying social factors in sodium consumption to reduce hypertension disparitiesK08HL121056 · NHLBI · STANFORD UNIVERSITY · PI BASU, SANJAY · 2014 to 2017
$599k
NHLBI NIH HHS K08 HL121056NIA NIH HHS P30 AG017253NIMHD NIH HHS DP2 MD010478
6 · The paper itself

Abstract

backgroundWhether to cover cardiovascular disease costs is an increasingly pressing question for low- and middle-income countries. We sought to identify the impact of expanding national insurance to cover primary prevention, secondary prevention, and tertiary treatment for cardiovascular disease in India. METHODS AND

resultsWe incorporated data from coverage experiments into a validated microsimulation model of myocardial infarction and stroke in India to evaluate the cost-effectiveness of alternate coverage strategies. Coverage of primary prevention alone saved 3.6 million disability-adjusted life-years (DALY) per annum at an incremental cost-effectiveness ratio of $469 per DALY averted when compared with the status quo of no coverage. Coverage of primary and secondary preventions was dominated by a strategy of covering primary prevention and tertiary treatment, which prevented 6.6 million DALYs at an incremental cost-effectiveness ratio of $2241 per DALY averted, when compared with that of primary prevention alone. The combination of all 3 categories yielded the greatest impact at an incremental cost per DALY averted of $5588 when compared with coverage of primary prevention plus tertiary treatment. When compared with the status quo of no coverage, coverage of all 3 categories of prevention/treatment yielded an incremental cost-effectiveness ratio of $1331 per DALY averted. In sensitivity analyses, coverage of primary preventive treatments remained cost-effective even if adherence and access to therapy were low, but tertiary coverage would require avoiding unnecessary procedures to remain cost-effective.

conclusionsCoverage of all 3 major types of cardiovascular treatment would be expected to have high impact and reasonable cost-effectiveness in India across a broad spectrum of access and adherence levels.

Indexed as

Health Care CostsCardiovascular DiseasesComputer SimulationCost-Benefit AnalysisCost SavingsDeveloping CountriesHealth Services AccessibilityHumansIndiaInsurance CoverageInsurance, HealthModels, EconomicNational Health ProgramsPatient CompliancePreventive Health ServicesPrimary Preventioncost-effectivenessdeveloping countrieshealthcare economics and organizationshealth policyinsurancemyocardial infarctionstroke

Identifiers

PMID26555122
PMCPMC4801228

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.