Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia:

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) together contribute to the largest burden of morbidity (14% of disability-adjusted life years) and mortality (over 30% of all deaths) in South Asia.T2DM doubles the risk of developing CVD, and approximately half of patients with T2DM are known to be hypertensive.By 2030, it is projected that there will be 120.9 million people with diabetes in South Asia (90–95% of these will have T2DM), more than double the number affected in North America or Europe.

South Asians experience higher case fatality rates and rates of premature death due to CVD (deaths occurring at least 10–15 years younger) than the rest of the Western world.A report in 2010 suggested that the total annual income loss to households affected by CVDs in India was 144–158 billion INR. The WHO estimates that India will lose US$237 billion due to heart disease, stroke and diabetes, which will slow the growth in India’s GDP (gross domestic product) by 1% over the next 10 years, thereby contributing to poverty. The mortality and morbidity due to CVD/T2DM thus impose a huge economic burden on individuals, families and society, the health system, and the economy as a whole.

CVD and T2DM share various common risk factors (unhealthy diet, physical inactivity, tobacco use, high blood pressure, dyslipidaemia and stress), and hence there is considerable overlap in strategies used to control these diseases.

While the efficacy and safety of various interventions have been tested by several randomised controlled clinical trials and subsequent systematic reviews and meta-analyses, little is known about the cost-effectiveness of these interventions from the perspective of either the patient or the healthcare system.

Full Systematic Review Protocol on the issue was published by Singh K , Sekaran AMC , Bhaumik S et al  recently in BMJ Open and is available here (Click) (Open Access )

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