Table 4.
Results of cost-saving and health-improving scenarios.
| Scenario | Patients changing drugs | DALYs avoided (discounted) | Lifetime cost saving to NHIS, GH¢ millions (discounted) | Cost savings (vs current practice), GH¢ millions (undiscounted) |
|||||
|---|---|---|---|---|---|---|---|---|---|
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Total 1-5 | ||||
| 1. 10% cut in mean drug prices | 0 | 0 | 93.7 | 3.3 | 6.5 | 6.3 | 6.1 | 5.9 | 28.0 |
| 2. 10% shift from ACEi/ARB/BB to TZD | 6050 | 3471 | 19.1 | 0.7 | 1.4 | 1.3 | 1.3 | 1.2 | 5.9 |
| 3. 10% shift from CCB to TZD | 13 033 | –6135 | 67.9 | 2.4 | 4.6 | 4.5 | 4.4 | 4.2 | 20.2 |
| 4. Prescribe TZD to 10% of patients diagnosed with hypertension who are not currently treated | 9170 | 10 776 | 2.16 | 0.06 | 0.16 | 0.15 | 0.14 | 0.14 | 0.51 |
| 5. Offer screening to 5% of NHIS patients older than 40 y without a diagnosis of hypertension | 104 476 invited for screening, 71 044 screened, 8997 offered TZD | 5512 | −5.07 | −4.20 | −0.07 | −0.07 | −0.06 | −0.06 | −4.47 |
ACEi indicates angiotension-converting enzyme inhibitor; ARB, angiotension receptor blocker; BB, beta-blocker; CCB, calcium channel blocker; DALYs, disability-adjusted life-years; GH¢, Ghana cedis; NHIA, National Health Insurance Authority; NHIS, National Health Insurance Scheme; TZD, thiazide-like diuretic.