评估巴基斯坦COBRA-BPS计划的长期成本效益
Carlos Chivardi1, Zainab Samad2,3, Tao Chen4
1Centre for Health Economics, University of York, York, UK.
BMJ public health
|December 10, 2025
概括
巴基斯坦高血压管理的COBRA-BPS计划在低值时成本效益有限,但在高值时成本效益更高. 它显著减少了心血管事件,由于下游节省,每DALY的成本降低了.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 心血管疾病管理管理
背景情况:
- 控制血压和降低风险 - 孟加拉国,巴基斯坦,斯里兰卡 (COBRA-BPS) 计划是一个基于社区的高血压管理计划.
- 之前的分析认为COBRA-BPS有效,但由于高成本和忽视的好处,如避免心血管事件和节省成本,因此不具有成本效益.
- 本研究重新评估了COBRA-BPS在巴基斯坦的长期成本效益,考虑到其特定的医疗保健资源限制.
研究的目的:
- 与巴基斯坦的标准护理 (SoC) 相比,评估COBRA-BPS计划的长期成本效益.
- 将避免的心血管事件和相关的成本节约纳入成本效益分析.
- 通过巴基斯坦特定的门和敏感性分析来评估成本效益.
主要方法:
- 使用马尔科夫模型估计长期成本和健康结果 (寿命年,DALYs).
- 使用增量成本效益比率 (ICER) 和净货币收益统计数据来确定成本效益.
- 分析使用了每日183美元,500美元和1000美元的门,避免了敏感性分析.
主要成果:
- 与SoC相比,COBRA-BPS计划导致成本更高 (105美元的增量成本),但健康收益也更大 (0.41 DALYs被避免).
- 增量成本效益比率 (ICER) 计算为每DALY避免252美元.
- COBRA-BPS 显著减少了心血管事件,从而大大降低了下游成本.
结论:
- COBRA-BPS在183美元/DALY值时显示边际成本效益,但在更高的值 (500美元,1000美元) 时变得具有成本效益.
- 该计划有效地减少了心血管事件,从而大大节省了以前分析中没有捕捉到的成本.
- 这项研究强调了考虑下游效益和特定国家经济背景的重要性,以准确评估卫生干预措施的成本效益.
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