Table 3.
Relative efficiency of the treat-to-target (TTT), benefit-based tailored treatment (BTT), or hybrid approach (based on current World Health Organization guidelines), utilizing current estimates of utilizing current estimates of blood pressure levels, blood pressure treatment access, other risk factors, and treatment benefit for populations in China and India. Uncertainty intervals are in parentheses.*
| Outcome | People treated identically by all three strategies |
People treated most intensively by TTT |
People treated most intensively by BTT |
People treated most intensively by Hybrid |
|---|---|---|---|---|
| China | ||||
| Number of people treated (million n) | 2.1 (1.1–3.1) | 62.3 (59–65.6) | 36.6 (27.8–45.4) | 39.4 (36.8–42) |
| Total DALYs averted (millions) | 0.8 (0.5–1.1) | 7.4 (7.1–7.7) | 12.4 (10.2–14.6) | 7.3 (6.9–7.7) |
| $/DALY among treated | 401.4 (222.7–581.7) | 438.2 (401.6–475) | 271.7 (216.6–328.6) | 436.9 (317.9–558.8) |
| DALYs averted per 1000 patient-years of pharmacotherapy | 38.1 (37.7–38.5) | 11.9 (10.9–12.9) | 33.9 (28.2–39.6) | 18.5 (17.8–19.2) |
| India | ||||
| Number of people treated (million n) | 4.1 (3.2–5) | 50.8 (47.8–53.8) | 28.8 (13.9–43.7) | 21.3 (19.6–23) |
| Total DALYs averted (millions) | 1.4 (1.2–1.6) | 5.1 (4.8–5.4) | 10 (7.6–12.4) | 4.8 (4.6–5) |
| $/DALY among treated | 359.1 (293.2–427) | 404.4 (294.5–514.4) | 192.9 (165.4–223.5) | 359.8 (85.3–637.1) |
| DALYs averted per 1000 patient-years of pharmacotherapy | 34.1 (31.3–36.9) | 10.0 (9.1–10.9) | 34.7 (30.2–39.2) | 22.5 (21.8–23.2) |
Uncertainty intervals (in parentheses) were determined by 10,000 iterations with multivariable Monte Carlo sampling from normal distributions constructed from the mean and standard deviation of estimated values of all input parameters, including the CVD risk estimation equations. Note: The uncertainty range for results of the BTT strategy are greater than for the TTT strategy because it depends on CVD risk estimation, which can be impacted by errors in measurement of BP, cholesterol, and knowledge of diabetes diagnosis and prior CVD history; by contrast, the TTT treatment decision was only affected by clinical errors in measurement of BP and knowledge of diabetes diagnosis.