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牛奶粉强化钾和植物固醇以降低马来西亚成年人群心血管事件风险:成本效益分析。

Milk Powder Fortified with Potassium and Phytosterols to Decrease the Risk of Cardiovascular Events among the Adult Population in Malaysia: A Cost-Effectiveness Analysis.

机构信息

Nestlé Research Center, 1000 Lausanne, Switzerland.

Università della Svizzera Italiana, 6900 Lugano, Switzerland.

出版信息

Nutrients. 2019 May 30;11(6):1235. doi: 10.3390/nu11061235.

Abstract

This study evaluated the cost-effectiveness of the consumption of a milk powder product fortified with potassium (+1050.28 mg/day) and phytosterols (+1200 mg/day) to lower systolic blood pressure and low-density lipoprotein cholesterol, respectively, and, therefore, the risk of myocardial infarction (MI) and stroke among the 35-75-year-old population in Malaysia. A Markov model was created against a do-nothing option, from a governmental perspective, and with a time horizon of 40 years. Different data sources, encompassing clinical studies, practice guidelines, grey literature, and statistical yearbooks, were used. Sensitivity analyses were performed to evaluate the impact of uncertainty on the base case estimates. With an incremental cost-effectiveness ratio equal to international dollars (int$) 22,518.03 per quality-adjusted life-years gained, the intervention can be classified as very cost-effective. If adopted nationwide, it would help prevent at least 13,400 MIs, 30,500 strokes, and more than 10,600 and 17,100 MI- and stroke-related deaths. The discounted cost savings generated for the health care system by those who consume the fortified milk powder would amount to int$8.1 per person, corresponding to 0.7% of the total yearly health expenditure per capita. Sensitivity analyses confirmed the robustness of the results. Together with other preventive interventions, the consumption of milk powder fortified with potassium and phytosterols represents a cost-effective strategy to attenuate the rapid increase in cardiovascular burden in Malaysia.

摘要

本研究评估了消费强化奶粉(富含钾元素 1050.28 毫克/天和植物固醇 1200 毫克/天)的成本效益,分别降低收缩压和低密度脂蛋白胆固醇,从而降低心肌梗死(MI)和中风风险。在马来西亚,35-75 岁人群中。从政府的角度来看,创建了一个针对不作为选项的马尔可夫模型,并设定了 40 年的时间范围。使用了不同的数据来源,包括临床研究、实践指南、灰色文献和统计年鉴。进行了敏感性分析,以评估不确定性对基本情况估计的影响。干预措施的增量成本效益比为每获得一个质量调整生命年的国际元(int$)22518.03,可归类为非常有效。如果在全国范围内采用,它将有助于预防至少 13400 例 MI、30500 例中风,以及超过 10600 例和 17100 例 MI 和中风相关死亡。那些食用强化奶粉的人将为医疗保健系统节省的成本折扣每人 8.1 国际元,相当于人均每年卫生总支出的 0.7%。敏感性分析证实了结果的稳健性。与其他预防措施相结合,食用强化钾和植物固醇的奶粉是减轻马来西亚心血管负担快速增加的一种具有成本效益的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7762/6627836/7b796501b9c8/nutrients-11-01235-g001.jpg

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