Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Cardiology Reviews
  4. Volume 20, Issue 6
  5. Article
Volume 20, Issue 6
  • ISSN: 1573-403X
  • E-ISSN:

Abstract

Background

Cardiovascular diseases (CVDs) continue to be the primary cause of mortality globally and invariably in India as well. The rapid upsurge in the prevalence of CVDs in India has created a pressing need to promote contemporary, sustainable, and cost-effective interventions to tackle the CVD burden. This systematic review integrates the research-based evidence of the cost-effectiveness of various interventions that can be adapted to control CVDs in India.

Methods

Databases, namely, PubMed, Cochrane Library, Embase, and Google Scholar, were searched for data on the economic evaluation of interventions targeting CVD based on the Indian population for a period of 30 years (1991-2021). Two reviewers assessed the articles for eligibility, and data were extracted from the shortlisted articles as per a predefined template, including the quantification of methodological aspects.

Results

In total, 1249 studies were examined, out of which 23 completely met the inclusion criteria for full-text review. A total of 16 studies were based solely on the Indian population, while the rest (7) included South Asia/Asia for the intervention, of which India was a participant nation. Most of the economic evaluations targeted treatment-based or pharmacological interventions (14) for CVDs. The evaluations were based on Decision-based models (10), Randomized controlled Trials (RCTs) (9), and Observational studies (4). The cost-effectiveness ratio for the included studies exhibited a diverse range due to variations in methodological approaches, such as differences in study settings, populations, and inconsistencies in study design. The mean ICER (Incremental Cost-effectiveness ratio) for primordial and primary preventions was found to be 3073.8 (US $2022) and 17489.9 (US $2022), respectively. Moreover, the combined mean value for secondary and tertiary prevention was 2029.6 (US$2022).

Conclusion

The economic evidence of public health interventions are expanding, but their focus is restricted towards pharmacological interventions. There is an urgency to emphasize primordial and primary prevention for better outcomes in health economics decision-making. Technology-based avenues for intervention need more exploration in order to cater to a large population like India.

© 2024 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/ccr/10.2174/011573403X309363240730095253
2024-11-01
2024-11-22

  • From This Site

    /content/journals/ccr/10.2174/011573403X309363240730095253
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. The changing patterns of cardiovascular diseases and their risk factors in the states of India: The global burden of disease study 1990–2016.Lancet Glob. Health20186e1339e135110.1016/S2214‑109X(18)30407‑8
     [Google Scholar]
  2. Economic burden of heart disease in India, coronary artery disease in Asian Indians. Available from: https://cadiresearch.org/topic/asian-indian-heart-disease/cadiindia/economic-burden (accessed on 2 February 2021)
  3. GuptaR. GupthaS. JoshiR. XavierD. Translating evidence into policy for cardiovascular disease control in India.Health Res. Policy Syst.201191810.1186/1478‑4505‑9‑8 21306620
     [Google Scholar]
  4. GuptaI. RoyA. Economic studies on non-communicable diseases and injuries in India: A systematic review.Appl. Health Econ. Health Policy201816330331510.1007/s40258‑018‑0370‑1 29611047
     [Google Scholar]
  5. DrummondM.F. SculpherM.J. TorranceG.W. O’BrienB.J. StoddartG.L. Methods for the economic evaluation of health care programs.2nd edOxfordOxford University Press1997
     [Google Scholar]
  6. HigginsJ.P.T. ThomasJ. ChandlerJ. CumpstonM. LiT. PageM.J. Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023). 2023. Available from: www.training.cochrane.org/handbook
  7. AbidiS. LabaniS. SinghA. AsthanaS. AjmeraP. Economic evaluation of human papillomavirus vaccination in the Global South: A systematic review.Int. J. Public Health20206571097111110.1007/s00038‑020‑01431‑1 32712694
     [Google Scholar]
  8. Annual averages in Annual Inflation Rates table, US Inflation Calculator. Available from: https://www.usinflationcalculator.com/inflation/current-inflationrates/ (accessed 15 Nov 2023)
  9. SinghK. CrossanC. LabaT.L. Cost-effectiveness of a fixed dose combination (polypill) in secondary prevention of cardiovascular diseases in India: Within-trial cost-effectiveness analysis of the UMPIRE trial.Int. J. Cardiol.2018262717810.1016/j.ijcard.2018.03.082 29622506
     [Google Scholar]
  10. ShafiqN. MalhotraS. PandhiP. SharmaN. BhallaA. GroverA. A randomized controlled clinical trial to evaluate the efficacy, safety, cost-effectiveness and effect on PAI-1 levels of the three low-molecular-weight heparins--enoxaparin, nadroparin and dalteparin. The ESCAPe-END study.Pharmacology200678313614310.1159/000096484 17057417
     [Google Scholar]
  11. LamyA. TongW. DevereauxP.J. The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year.Ann. Thorac. Surg.20149851620162510.1016/j.athoracsur.2014.06.046 25261272
     [Google Scholar]
  12. SanmukhaniJ. ShahV. Statins.J. Postgrad. Med.201056319620010.4103/0022‑3859.68649 20739765
     [Google Scholar]
  13. AnchalaR. KaptogeS. PantH. Di AngelantonioE. FrancoO.H. PrabhakaranD. Evaluation of effectiveness and cost-effectiveness of a clinical decision support system in managing hypertension in resource constrained primary health care settings: results from a cluster randomized trial.J. Am. Heart Assoc.201541e00121310.1161/JAHA.114.001213 25559011
     [Google Scholar]
  14. OrtegónM LimS ChisholmD MendisS Cost effectiveness of strategies to combat cardiovascular disease, diabetes, and tobacco use in sub-Saharan Africa and South East Asia: mathematical modelling study.BMJ 2012; 344(mar02 1): e607.10.1136/bmj.e60722389337
     [Google Scholar]
  15. ChisholmD. SandersonK. Ayuso-MateosJ.L. SaxenaS. Reducing the global burden of depression.Br. J. Psychiatry2004184539340310.1192/bjp.184.5.393 15123502
     [Google Scholar]
  16. CecchiniM. SassiF. LauerJ.A. LeeY.Y. Guajardo-BarronV. ChisholmD. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness.Lancet201037697541775178410.1016/S0140‑6736(10)61514‑0 21074255
     [Google Scholar]
  17. MurrayC.J.L. LauerJ.A. HutubessyR.C.W. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: A global and regional analysis on reduction of cardiovascular-disease risk.Lancet2003361935971772510.1016/S0140‑6736(03)12655‑4 12620735
     [Google Scholar]
  18. DonaldsonE.A. WatersH.R. AroraM. VargheseB. DaveP. ModiB. A cost-effectiveness analysis of India’s 2008 prohibition of smoking in public places in Gujarat.Int. J. Environ. Res. Public Health2011851271128610.3390/ijerph8051271 21655118
     [Google Scholar]
  19. BrownH.S.III StiglerM. PerryC. DhavanP. AroraM. ReddyK.S. The cost-effectiveness of a school-based smoking prevention program in India.Health Promot. Int.201328217818610.1093/heapro/dar095 22271928
     [Google Scholar]
  20. BasuS. BendavidE. SoodN. Health and economic implications of national treatment coverage for cardiovascular disease in India.Circ. Cardiovasc. Qual. Outcomes20158654155110.1161/CIRCOUTCOMES.115.001994 26555122
     [Google Scholar]
  21. JhaP. ChaloupkaF.J. MooreJ. Disease control priorities in developing countriesIn: Chapter 46 Tobacco Addiction. Washington (DC): The International Bank for Reconstruction and Development / The World Bank. New York: Oxford University Press2006
     [Google Scholar]
  22. Schulman-MarcusJ. PrabhakaranD. GazianoT.A. Pre-hospital ECG for acute coronary syndrome in urban India: A cost-effectiveness analysis.BMC Cardiovasc. Disord.20101011310.1186/1471‑2261‑10‑13 20222987
     [Google Scholar]
  23. BasuS. YudkinJ.S. SussmanJ.B. MillettC. HaywardR.A. Alternative strategies to achieve cardiovascular mortality goals in China and India.Circulation2016133984084810.1161/CIRCULATIONAHA.115.019985 26762520
     [Google Scholar]
  24. MegiddoI. ChatterjeeS. NandiA. LaxminarayanR. Cost-effectiveness of treatment and secondary prevention of acute myocardial infarctiont in India: A modeling study.Glob. Heart201494391398.e310.1016/j.gheart.2014.07.002 25592792
     [Google Scholar]
  25. RodgersA. LawesC.M.M. GazianoT.A. Disease control priorities in developing countries.In: Chapter 45 The Growing Burden of Risk from High Blood Pressure, Cholesterol, and Bodyweight. 2nd ed. Washington (DC): The international bank for reconstruction and development / The World Bank. New York: Oxford University Press2006
     [Google Scholar]
  26. AhujaR.C. MitraM.K. SaranR.K. RastogiA.C. GoelD. A RCT to estimate cost effectiveness of antihypertensive regimes with or without diuretics for management of mild hypertension.J. Clin. Epidemiol.199750S2510.1016/S0895‑4356(97)87242‑3
     [Google Scholar]
  27. GazianoT.A. ReddyK.S. PaccaudF. Disease control priorities in developing countries.In: Chapter 33 Cardiovascular Disease. 2nd ed. Washington (DC): The international bank for reconstruction and development / The World Bank. New York: Oxford University Press2006
     [Google Scholar]
  28. LinJ.K. MoranA.E. Bibbins-DomingoK. Cost-effectiveness of a fixed-dose combination pill for secondary prevention of cardiovascular disease in China, India, Mexico, Nigeria, and South Africa: A modelling study.Lancet Glob. Health2019710e1346e135810.1016/S2214‑109X(19)30339‑0 31477544
     [Google Scholar]
  29. MalhotraS. BhargavaV.K. GroverA. PandhiP. SharmaY.P. A randomized trial to compare the efficacy, safety, cost and platelet aggregation effects of enoxaparin and unfractionated heparin (the ESCAPEU trial).Int. J. Clin. Pharmacol. Ther.200139311011510.5414/CPP39110 11396750
     [Google Scholar]
  30. NamboodiriK.K. SharmaY.P. BaliH.K. GroverA. Re-use of explanted DDD pacemakers as VDD- clinical utility and cost effectiveness.Indian Pacing Electrophysiol. J.20044139 16943883
     [Google Scholar]
  31. NanjappaM.C. DorrosG. Hemanna SettyS.K. The Indian experience of percutaneous transvenous mitral commissurotomy: Comparison of the triple lumen (inoue) and double lumen (accura) variable sized single balloon with regard to procedural outcome and cost savings.J. Interv. Cardiol.199811210711210.1111/j.1540‑8183.1998.tb00105.x
     [Google Scholar]
  32. KamathN.A. PatelR.S. SharmaK.H. PatelN. ThakkarA. Cost-effectiveness analysis of nebivolol and metoprolol in essential hypertension: A pharmacoeconomic comparison of antihypertensive efficacy of beta blockers.Indian J. Pharmacol.201446548548910.4103/0253‑7613.140577 25298575
     [Google Scholar]
  33. SengottuveluG. ChakravarthyB. RajendranR. RaviS. Clinical usefulness and cost effectiveness of fractional flow reserve among Indian patients (FIND study).Catheter. Cardiovasc. Interv.2016885E139E14410.1002/ccd.25517 24740902
     [Google Scholar]
  34. TuriZ.G. ReyesV.P. RajuB.S. Percutaneous balloon versus surgical closed commissurotomy for mitral stenosis. A prospective, randomized trial.Circulation19918341179118510.1161/01.CIR.83.4.1179 2013139
     [Google Scholar]
  35. WillettW.C. KoplanJ.P. NugentR. Disease control priorities in developing countries.In: Chapter 44 prevention of chronic disease by means of diet and lifestyle changes . 2nd ed. Washington (DC): The international bank for reconstruction and development / The World Bank. New York: Oxford University Press2006
     [Google Scholar]
  36. KrausW. PowellK. HaskellW.L. Physical activity, all-cause and cardiovascular mortality, and cardiovascular disease.Med. Sci. Sports Exerc.20195161270128110.1249/MSS.0000000000001939 31095084
     [Google Scholar]
  37. ReavellJ. HopkinsonM. ClarkesmithD. LaneD.A. Effectiveness of cognitive behavioral therapy for depression and anxiety in patients with cardiovascular disease: A systematic review and meta-analysis.Psychosom. Med.201880874275310.1097/PSY.0000000000000626 30281027
     [Google Scholar]
  38. BrownA. BarnesC. ByaruhangaJ. Effectiveness of technology-enabled knowledge translation strategies in improving the use of research in public health: Systematic review.J. Med. Internet Res.2020227e1727410.2196/17274 32735231
     [Google Scholar]
  39. CortigianiL. BigiR. BovenziF. MolinaroS. PicanoE. SicariR. Prognostic implication of appropriateness criteria for pharmacological pharmacologic stress echocardiography performed in an outpatient clinic.Circ. Cardiovasc. Imaging20125329830510.1161/CIRCIMAGING.111.971242 22467675
     [Google Scholar]
  40. MansourI.N. LangR.M. AburuwaidaW.M. BhaveN.M. WardR.P. Evaluation of the clinical application of the ACCF/ASE appropriateness criteria for stress echocardiography.J. Am. Soc. Echocardiogr.201023111199120410.1016/j.echo.2010.07.008 20724108
     [Google Scholar]
  41. SonaglioniA. RigamontiE. Appropriate use criteria implementation with modified Haller index for predicting stress echocardiographic results and outcome in a population of patients with suspected coronary artery disease.Int. J. Cardiovasc. Imaging2021371029172930
     [Google Scholar]
/content/journals/ccr/10.2174/011573403X309363240730095253
Loading
A Systematic Review of Economic Evidence of Cardiovascular Interventions in India
Current Cardiology Reviews 20, E300724232473 (2024); https://doi.org/10.2174/011573403X309363240730095253
/content/journals/ccr/10.2174/011573403X309363240730095253
/content/journals/ccr/10.2174/011573403X309363240730095253
Loading

Data & Media loading...

Supplements

file format download Download

  • Article Type:     Review Article
Keyword(s): cardiovascular diseases; cardiovascular interventions; cost-effectiveness analysis; Economic evaluation; health interventions; pharmacological interventions

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test