Related Experiment Video
Updated: Jul 18, 2025
Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Cost-effectiveness of implementing risk-based cardiovascular disease (CVD) management using updated WHO CVD risk
Parthibane Sivanantham1, Mathan Kumar S1, Saravanan Essakky1
1Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Insights
Implementing updated World Health Organization (WHO) cardiovascular disease (CVD) screening strategies in India is cost-effective. The two-stage screening approach offers greater cost-effectiveness, supporting population-based CVD risk assessment and management.
Area of Science:
- Public Health
- Health Economics
- Cardiovascular Disease Prevention
Background:
- The World Health Organization (WHO) updated cardiovascular disease (CVD) risk prediction charts in 2019.
- WHO recommends population-based CVD risk assessment and management using these charts to control CVDs.
Purpose of the Study:
- To evaluate the cost-effectiveness of implementing risk-based CVD management in India using updated WHO CVD risk prediction charts.
- To compare two community-based CVD risk screening strategies against a no-screening scenario.
Main Methods:
- A decision tree combined with a Markov Model simulated two screening strategies: two-stage (non-lab followed by lab-based assessment) and single-stage (lab-based only).
- A simulated cohort of individuals aged ≥40 years with no prior CVD events was analyzed over a lifetime horizon.
- Incremental cost-effectiveness ratios (ICERs) were calculated, with data sourced from primary and secondary studies.
Main Results:
- Both two-stage (US$ 105 per QALY) and single-stage (US$ 1073 per QALY) screening strategies were found to be cost-effective at 40% implementation coverage.
- Implementing CVD screening is projected to significantly reduce the incidence of CVD events compared to no screening.
Conclusions:
- Both CVD screening strategies are cost-effective in India, with the two-stage approach being more cost-effective.
- The findings support the implementation of population-based CVD screening programs in India.
- Further research should examine the budget impact of these strategies at various implementation levels.
Introduction:
The World Health Organization (WHO) has released the updated cardiovascular disease (CVD) risk prediction charts in 2019 for each of the 21 Global Burden of Disease regions. The WHO advocates countries to implement population-based CVD risk assessment and management using these updated charts for preventing and controlling CVDs.
Objective:
To assess the cost-effectiveness of implementing risk-based CVD management using updated WHO CVD risk prediction charts in India.
Methods:
We developed a decision tree combined with Markov Model to simulate implementing two community-based CVD risk screening strategies (interventions) compared with the current no-screening scenario. In the first strategy, the whole population is initially screened using the WHO non-lab-based CVD risk assessment method, and those with ≥10% CVD risk are subjected to WHO lab-based CVD risk assessment (two-stage screening). In the second strategy, the whole population is subjected only to the lab-based CVD risk assessment (single-stage screening). A mathematical cohort of those aged ≥40 years with no history of CVD events was simulated over a lifetime horizon with three months of cycle length. Data for the model were derived from a primary study and secondary sources. Incremental cost-effectiveness ratios (ICERs) were determined for the screening strategies and sensitivity analyses.
Results:
The discounted Incremental cost-effectiveness ratio per QALY gained for both the two-stage (US$ 105; ₹ 8,656) and single-stage (US$ 1073; ₹ 88,588) screening strategies were cost-effective at an implementation effect of 40% when compared with no screening scenario. Implementing CVD screening strategies are estimated to cause substantial reduction in the number of CVD events in the population compared to the no screening scenario.
Conclusion:
In India, both CVD screening strategies would be cost-effective, and implementing the two-staged screening would be more cost-effective. Our findings support implementing population-based CVD screening in India. Future studies shall assess the budget impact of these strategies at different implementation coverage levels.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:26Coronary Artery Disease IV: Preventive Measures
01:21Rheumatic Heart Disease III: Medical Management
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:27Coronary Artery Disease V: Interprofessional Care