Budget impact and cost-effectiveness analyses of the COBRA-BPS multicomponent hypertension management programme in rural communities in Bangladesh, Pakistan, and Sri Lanka

作者：Eric Finkelstein, Anirudh Krishnan, Aliya Naheed, Imtiaz Jehan, H Asita de Silva, Mihir Gandhi, Ching Wee Lim, Nantu Chakma, Dileepa Senajith Ediriweera, Jehanzeb Khan, Anuradhani Kasturiratne, Samina Hirani, A K M Solayman, Tazeen H. Jafar, Tazeen H. Jafar, Aliya Naheed, Imtiaz Jehan, Asita de Silva, Mihir Gandhi, Eric Finkelstein, Helena Legido‐Quigley, Marcel Bilger, Liang Feng, Saeideh Tavajoh, Ching Wee Lim, Anirudh Krishnan, Cecille Lintag, Pryseley Nkouibert Assam, Rajesh Babu Moorakanda, Xinyi Lin, Edwin SY Chan, Yiheng Zheng, John D. Clemens, Mohammad Abul Hasnat, Nantu Chakma, Dewan S Alam, Sonia Pervin, Ali Tanweer Siddiquee, Rubhana Rajib, Mohammad Tauhidul Islam, A K M Solayman, AamirHameed Khan, Sahar Senan, Hamid Farazdiq, Gulshan Himani, Samina Hirani, Jehanzeb Khan, Syed Omair Nadeem, Hunaina Shahab, Ayesha Khan, Anuradhani Kasturiratne, Natasha Luke, Chamini de Silva, Manuja Niranshi Perera, Channa D Ranasinha, Dileepa Senajith Ediriweera, Shah Ebrahim, Elizabeth L. Turner, Joep Perk, Richard D. Smith, Anne Mills, Elizabeth Allen, Kate Hunt, Jill Jones, Andrew Farmer, Doris Young, Bruce Neal, Say Beng Tan · 发表于：The Lancet Global Health · 年份：2021 · DOI：10.1016/s2214-109x(21)00033-4 · 被引用次数：37 · 研究领域：Blood Pressure and Hypertension Studies、Global Maternal and Child Health、Sodium Intake and Health

BACKGROUND: COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multi-component hypertension management programme that is led by community health workers, has been shown to be efficacious at reducing systolic blood pressure in rural communities in Bangladesh, Pakistan, and Sri Lanka. In this study, we aimed to assess the budget required to scale up the programme and the incremental cost-effectiveness ratios. METHODS: In a cluster-randomised trial of COBRA-BPS, individuals aged 40 years or older with hypertension who lived in 30 rural communities in Bangladesh, Pakistan, and Sri Lanka were deemed eligible for inclusion. Costs were quantified prospectively at baseline and during 2 years of the trial. All costs, including labour, rental, materials and supplies, and contracted services were recorded, stratified by programme activity. Incremental costs of scaling up COBRA-BPS to all eligible adults in areas covered by community health workers were estimated from the health ministry (public payer) perspective. FINDINGS: Between April 1, 2016, and Feb 28, 2017, 11 510 individuals were screened and 2645 were enrolled and included in the study. Participants were examined between May 8, 2016, and March 31, 2019. The first-year per-participant costs for COBRA-BPS were US$10·65 for Bangladesh, $10·25 for Pakistan, and $6·42 for Sri Lanka. Per-capita costs were $0·63 for Bangladesh, $0·29 for Pakistan, and $1·03 for Sri Lanka. Incremental cost-eff...