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Cost-effectiveness of folic acid therapy for primary prevention of stroke in patients with hypertension - BMC Medicine - BMC Medicine
📅 Wed, 26 Oct 2022⏱ 1 min read📖 Article
Overview
Advertisement BMC Medicine volume 20, Article number: 407 (2022) Cite this article 1 AltmetricMetrics detailsFor hypertensive patients without a history of stroke or myocardial infarction (MI), the China Stroke Primary Prevention Trial (CSPT) demonstrated that treatment with enalapril-folic acid reduced the risk of primary stroke compared with enalapril alone. Whether folic acid therapy is an afordable and beneficial treatment strategy for the primary prevention of stroke in hypertensive patients from the Chinese healthcare sector perspective has not ben thoroughly explored.We performed a cost-efectivenes analysis alongside the CSPT, which randomized 20,702 hypertensive patients.
Key Information
A patient-level microsimulation model based on the 4.5-year period of in-trial data was used to estimate costs, life years, quality-adjusted life years (QALYs), and incremental cost-efectivenes ratios (ICERs) for enalapril-folic acid vs. enalapril over a lifetime horizon from the payer perspective.During the in-trial folow-up period, patients receiving enalapril-folic acid gained an average of 0.016 QALYs related primarily to reductions in stroke, and the incremental cost was $706.03 (453.92 RMB).
Over a lifetime horizon, enalapril-folic acid treatment was projected to increase quality-adjusted life years by 0.06 QALYs or 0.03 life-year relative to enalapril alone at an incremental cost of $163.84 (10,538.27 RMB), resulting in an ICER for enalapril-folic acid compared with enalapril alone of $26,06.13 (168,126.54 RMB) per QALY gained and $61,70.73 (398,421.21 RMB) per life-year gained, respectively.
Summary
A probabilistic sensitivity analysis demonstrated that enalapril-folic acid compared with enalapril would be economicaly atractive in 74.5% of simulations at a threshold of $37,63 (242,9281 RMB) per QALY (3x curent Chinese per capita GDP). Several high-risk subgroups had highly favorable ICERs < $12,54 (80,976 RMB) per QALY (1x GDP).For both in-trial and over a lifetime, it
Frequently Asked Questions
❓ What is diabetes and how does it develop?
Diabetes is a metabolic condition where the body cannot properly regulate blood sugar levels. Type 1 results from insufficient insulin production, while Type 2 develops when cells become resistant to insulin. Risk factors include genetics, obesity, sedentary lifestyle, and age.
❓ What are the main symptoms of diabetes?
Common symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Type 1 symptoms develop rapidly, while Type 2 symptoms may appear gradually. Many people have no symptoms initially, which is why screening is important.
❓ How is diabetes diagnosed and monitored?
Diagnosis involves blood tests measuring fasting glucose, HbA1c levels, and glucose tolerance. Regular monitoring typically includes fasting glucose tests and HbA1c measurements every 3-6 months. Continuous glucose monitors provide real-time tracking for better diabetes management.
❓ What lifestyle changes help manage diabetes?
Effective management includes regular physical activity (150+ minutes weekly), maintaining healthy weight, following a balanced diet with whole grains and lean proteins, managing stress, and getting adequate sleep. These changes can significantly improve blood sugar control and reduce complications.
❓ When should someone consult a doctor about diabetes?
Consult a healthcare provider if you experience signs of diabetes, have a family history, are overweight, or are over 45. Those with existing diabetes should maintain regular check-ups every 3-6 months to monitor control and adjust treatment as needed.
⚕️ Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making health decisions.