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Protocol for the economic evaluation of the China Salt Substitute and Stroke Study (SSaSS)
Ka-Chun Li1, Maoyi Tian2,3, Bruce Neal2,4
1The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia kli@georgeinstitute.org.au.
Insights
This study evaluates the cost-effectiveness of a low-sodium salt substitute to reduce stroke risk in China. The intervention aims to lower cardiovascular disease burden through reduced dietary salt consumption.
Area of Science:
- Public Health
- Health Economics
- Cardiovascular Research
Background:
- Cardiovascular diseases (CVDs) are a leading global cause of mortality and morbidity.
- Reducing dietary salt intake is a recognized strategy for lowering blood pressure and CVD burden.
- Existing economic evidence on sodium reduction primarily focuses on the food industry and processed foods, with blood pressure as the main outcome.
Purpose of the Study:
- To conduct a within-trial economic evaluation of a low-sodium salt substitute intervention.
- To assess the cost-effectiveness and cost-utility of reducing stroke risk in China.
- To inform public health strategies for CVD prevention through dietary modifications.
Main Methods:
- Economic evaluation conducted alongside the 5-year Salt Substitute and Stroke Study, a large-scale cluster randomized controlled trial.
- Outcomes include quality of life (EuroQol-5-Dimensions) and major adverse cardiovascular events.
- Costs estimated from a healthcare system perspective using data from the New Rural Cooperative Medical Scheme.
Main Results:
- Cost-effectiveness and cost-utility analyses will determine the incremental cost-effectiveness ratio (ICER).
- ICER will be expressed as cost per cardiovascular event averted and cost per quality-adjusted life year (QALY) gained.
- Results will provide crucial economic data on the intervention's value.
Conclusions:
- The study protocol outlines a comprehensive economic evaluation of a novel CVD prevention strategy.
- Findings will contribute to understanding the economic impact of dietary interventions on cardiovascular health in China.
- Dissemination through peer-reviewed publications and international conferences is planned.
Introduction:
Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. This study protocol describes the planned within-trial economic evaluation of a low-sodium salt substitute intervention designed to reduce the risk of stroke in China.
Methods And Analyses:
The economic evaluation will be conducted alongside the Salt Substitute and Stroke Study: a 5-year large scale, cluster randomised controlled trial. The outcomes of interest are quality of life measured using the EuroQol-5-Dimensions and major adverse cardiovascular events. Costs will be estimated from a healthcare system perspective and will be sought from the routinely collected data available within the New Rural Cooperative Medical Scheme. Cost-effectiveness and cost-utility analyses will be conducted, resulting in the incremental cost-effectiveness ratio expressed as cost per cardiovascular event averted and cost per quality-adjusted life year gained, respectively.
Ethics And Dissemination:
The trial received ethics approval from the University of Sydney Ethics Committee (2013/888) and Peking University Institutional Review Board (IRB00001052-13069). Informed consent was obtained from each study participant. Findings of the economic evaluation will be published in a peer-reviewed journal and presented at international conferences.
Trial Registration Number:
ClinicalTrials.gov Registry (NCT02092090).
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