Supporting the Development of Evidence-Informed Policy Options: An Economic Evaluation of Hypertension Management in Ghana |
| |
| Institution: | 1. Global Health Development group, School of Public Health, Imperial College London, International Decision Support Initiative, London, England, UK;2. Southampton Health Technology Assessments Centre, University of Southampton, Southampton, England, UK;3. Ghana National Drugs Programme, Ministry of Health, Accra, Ghana;4. Pharmaceutical Services, Ministry of Health, Accra, Ghana;1. Global Health Development group, School of Public Health, Imperial College London, International Decision Support Initiative, London, England, UK;2. Southampton Health Technology Assessments Centre, University of Southampton, Southampton, England, UK;3. Ghana National Drugs Programme, Ministry of Health, Accra, Ghana;4. Pharmaceutical Services, Ministry of Health, Accra, Ghana |
| |
| Abstract: | ObjectivesUniversal healthcare coverage in low- and middle-income countries requires challenging resource allocation decisions. Health technology assessment is one important tool to support such decision making. The International Decision Support Initiative worked with the Ghanaian Ministry of Health to strengthen health technology assessment capacity building, identifying hypertension as a priority topic area for a relevant case study.MethodsBased on guidance from a national technical working group of researchers and policy makers, an economic evaluation and budget impact analysis were undertaken for the main antihypertensive medicines used for uncomplicated, essential hypertension. The analysis aimed to address specific policy questions relevant to the National Health Insurance Scheme.ResultsThe evaluation found that first-line management of essential hypertension with diuretics has an incremental cost per disability-adjusted life-year avoided of GH¢ 276 ($179 in 2017, 4% of gross national income per capita) compared with no treatment. Calcium channel blockers were more effective than diuretics but at a higher incremental cost: GH¢ 11 061 per disability-adjusted life-year avoided ($7189 in 2017; 160% of gross national income per capita). Diuretics provide better health outcomes at a lower cost than angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or beta-blockers. Budget impact analysis highlighted the potential for cost saving through enhanced price negotiation and increased use of better-value drugs. We also illustrate how savings could be reinvested to improve population health.ConclusionsEconomic evaluation enabled decision makers to assess hypertension medicines in a Ghanaian context and estimate the impact of using such evidence to change policy. This study contributes to addressing challenges associated with the drive for universal healthcare coverage in the context of constrained budgets. |
| |
| Keywords: | cardiovascular cost-effectiveness analysis evidence-based decision making Ghana health technology assessment HTA hypertension UHC universal health coverage |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
