Table 3.
Main assumptions for the cost-effectiveness analysis
| Parameters | Estimate (SD or range) | Distribution | Reference |
|---|---|---|---|
| Patient characteristics | |||
| Age, y | 60 (7.53) | Normal | CSPPT [6] |
| Male sex，% | 41% | Table | |
| Clinical characteristics | |||
| Total cholesterol, mg/dL | 213.6 (46) | Normal | CSPPT [6] |
| HDL-C, mg/dL | 52 (14) | Normal | |
| Baseline SBP, mm Hg | 139.7 (11.1) | Normal | |
| Smoking,% | 23% | Table | |
| Diabetes mellitus,% | 3% | Table | |
| Rates and probabilities | |||
| Morbidity rates, annual | |||
| Primary stroke | 1 − exp [λ ∗ (state)γ − λ ∗ (state + 1)γ] | Weibull | CSPPT [6] |
| Primary CHD |
1 − exp ((ln(1 − P))/10) P = 1 − S(t)exp(f[x, M]) f(x, M) = β1 ∗ (x1 − M1) + … + βp ∗ (xp − Mp) |
/ | CMCS [22] |
| Stroke relapse in 1 year | 17% | β | CKB study [23] |
| Stroke relapse after 1 year | 2–9% | β | |
| Stroke after CHD | 0.4% | β | The EUROPA study [24] |
| Stroke after post-CHD | 0.4% | β | |
| CHD relapse in 1 year | 2.5% | β | PEACE [25] |
| CHD relapse after 1 year | 1.2% | β | The EUROPA study [24] |
| CHD after stroke | 0.4% | β | CKB study [23] |
| CHD after post-stroke | 0.4% | β | |
| Mortality rates, annual | |||
| Non CVD related | 1.68–507.28‰ (Age-dependent) | β | Life table [26] |
| After stroke | 15% | β | CKB study [23] |
| After post-stroke | 3% | β | |
| After CHD | 2.8% | β | PEACE [25] |
| After post-CHD | 1.5% | β | The EUROPA study [24] |
| Drug cost per unit, $ (￥) | |||
| Enalapril |
$0.09 ($0.03–$0.22) ￥0.56 (￥0.2–￥1.44) |
γ | Local bidding Price or the National centralized drug procurement price [27, 28] (see Additional file 1: Table S3) |
| Enalapril-folic acid |
$0.74 ￥4.75 |
γ | |
| Angiotensin-converting enzyme inhibitors |
$0.13 ($0.11–$0.38) ￥0.83 (￥0.72–￥2.43) |
γ | |
| Angiotensin II receptor blockers |
$0.08 ($0.07–$0.54) ￥0.53 (￥0.48–￥3.48) |
γ | |
| Calcium channel blockers |
$0.25 ($0.14–$0.47) ￥1.60 (￥0.91–￥3.06) |
γ | |
| Diuretics |
$0.29 ($0.27–$0.30) ￥1.88 (￥1.72–￥1.95) |
γ | |
| β-blockers |
$0.03 ($0.02–$0.05) ￥0.21 (￥0.16–￥0.32) |
γ | |
| Lipid-lowering drugs |
$0.08 ($0.03–$0.65) ￥0.50 (￥0.17–￥4.19) |
γ | |
| Glucose-lowering drugs |
$0.04 ($0.03–$0.24) ￥0.24 (￥0.19–￥1.57) |
γ | |
| Antiplatelet drugs |
$0.05 ($0.05–$0.08) ￥0.34 (￥0.31–￥0.50) |
γ | |
| CVD hospitalization costs, $ (￥) (first 30 days) | |||
| Ischemic stroke |
$1529.18 (± 20%) ￥9863.20 (± 20%) |
γ | China’s Health Statistics Yearbook, 2021 [29] |
| Hemorrhagic stroke |
$3207.55 (± 20%) ￥20,688.70(± 20%) |
γ | |
| Coronary heart disease |
$4696.39 (± 20%) ￥30,291.70(± 20%) |
γ | |
| Rehabilitation costs per month, $ (￥)a | |||
| Rehabilitation training |
$200.93 (± 20%) ￥1296.00 (± 20%) |
γ | National Development and Reform Commission [30] (see Additional file 1: Table S4) |
| Rehabilitation checking |
$7.91 (± 20%) ￥51.00 (± 20%) |
γ | |
| Home care |
$465.12 (± 20%) ￥3000.00 (± 20%) |
γ | |
| Utility | |||
| Pre-CVD | 0.90 (0.12) | β | CSPPT [6] |
| Primary stroke (first year) | 0.76 | β | Du [31] |
| Primary stroke (after first year) | 0.79 | β | |
| Recurrent stroke (first year) | 0.30 | β | Wang [32] |
| Recurrent stroke (after first year) | 0.33 | β | |
| Primary CHD (first year) | 0.77 (0.75–0.78) | β | Goldsmith [33] |
| Primary CHD (after first year) | 0.89 (0.17) | β | Wang [34] |
| Recurrent CHD (first year) | 0.64 | β | Thomas [35] |
| Recurrent CHD (after first year) | 0.76 | β | |
| Treatment adherence | |||
| Enalaparil-folic acid | 0.692 (± 20%) | β | CSPPT [6] |
| Enalapril | 0.691 (± 20%) | β | |
| HR of primary stroke | 0.79 (0.68 -0.93) | β | |
| Disability rate | 0.39 (0.20–0.8)) | β | Salomon [8] |
| Rehabilitation rate after stroke | 0.58 (0–0.7) | β | Asakawa [36] |
| Annual discount rates for life years, costs, and QALYs | 5% (0–8%) | / | |
aPatients with disability after stroke