Table 2. Effectiveness and cost-effectiveness of implementing different BP control guidelines in untreated Chinese adults aged 35–84 y with hypertension, averaged from the projections for 2015–2025, the CVD Policy Model-China.
Each successive strategy is compared with the prior strategy. Results are in 2015 international dollars and 2015 Chinese RMB. All results reported as cost-saving describe strategies projected to be less costly and more effective than the prior strategy. Ninety-five percent uncertainty intervals were calculated from the results of 1,000 probabilistic simulations.
| Strategy* | Annual Number of Hypertensive Adults Newly Treated | Annual Total Stroke Events (95% Uncertainty Interval) | Annual Total Myocardial Infarction Events (95% Uncertainty Interval) | Annual QALYs, Millions (95% Uncertainty Interval) | Annual CVD Costs, Millions (95% Uncertainty Interval) † | ICERs (95% Uncertainty Interval) † |
|---|---|---|---|---|---|---|
| Status Quo case (projected China 2015–2025) | Not applicable | 5,548,000 | 1,511,000 | 653.92 | Int$74,200 | Not applicable |
| ¥261,300 | ||||||
| Control BP in all persons living with CHD or stroke (base case) | 5,807,000 | 5,458,000 (5,394,000–5,500,000) | 1,490,000 (1,478,000–1,498,000) | 654.00 (653.76–654.10) | Int$74,000 (Int$73,500–Int$74,400) | Cost-saving (cost saving—cost saving) |
| ¥260,300 (¥258,600–¥261,800) | Cost-saving (cost saving—cost saving) | |||||
| Strategy 1: Treat all stage two hypertension patients to goal of <140/90 if age 35–64 y, goal of 150/90 if age ≥65 | 62,258,000 | 4,965,000 (4,789,000–5,124,000) | 1,417,000 (1,393,000–1,435,000) | 654.85 (654.50–655.07) | Int$81,700 (Int$80,500–Int$82,900) | Int$9,000 (Int$7,000–Int$12,000) |
| ¥287,700 (¥283,200–¥291,800) | ¥32,000 (¥24,000–¥ 42,000) | |||||
| Strategy 2: Treat all stage two and stage one, goal of <140/90 for ages 35–64 y, goal of 150/90 if age ≥65 | 173,950,000 | 4,858,000 (4,644,000–5,035,000) | 1,398,000 (1,368,000–1,419,000) | 655.10 (654.72–655.35) | Int$85,000 (Int$83,400–Int$86,500) | Int$13,000§ (Int$10,000–Int$18,000) |
| ¥299,300 (¥293,700–¥304,400) | ¥47,000 (¥34,000–¥64,000) |
* All guideline strategies affect adults not previously treated for hypertension only, i.e., “aware/treated/uncontrolled” population not treated.
† To convert cost input to Chinese currency, multiply by PPP rate (in this case, 3.52). To convert to $US using the current official exchange rate, multiply by (PPP/exchange rate), for example, 3.52/6.20, or by 5.68.
§ Less than 2 x China’s GDP per capita.