Tufts University Friedman School of Nutrition and Policy, 150 Harrison Ave, Boston, MA, 02111, USA.
Tufts Clinical Evidence Synthesis Center, Tufts Medical Center, 800 Washington Street, box 63, Boston, MA, 02111, USA.
BMC Public Health. 2020 Apr 25;20(1):558. doi: 10.1186/s12889-020-08642-4.
Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 oz (42.5 g) of nut intake may reduce the risk of cardiovascular disease. Previous studies have focused on the cost-effectiveness of other foods or dietary factors on primary cardiovascular disease prevention, yet not in almond consumption. This study aimed to examine the cost-effectiveness of almond consumption in cardiovascular disease primary prevention.
PERSPECTIVE & SETTING: This study assessed the cost-effectiveness of consuming 42.5 g of almond from the U.S. healthcare sector perspective.
A decision model was developed for 42.5 g of almond per day versus no almond consumption and cardiovascular disease in the U.S.
Parameters in the model were derived from the literature, which included the probabilities of increasing low-density lipoprotein cholesterol, developing acute myocardial infarction and stroke, treating acute myocardial infarction, dying from the disease and surgery, as well as the costs of the disease and procedures in the U.S. population, and the quality-adjusted life years. The cost of almonds was based on the current price in the U.S. market. Sensitivity analyses were conducted for different levels of willingness-to-pay, the probabilistic sensitivity analysis, ten-year risk prevention, different costs of procedures and almond prices, and patients with or without cardiovascular disease.
The almond strategy had $363 lower cost and 0.02 higher quality-adjusted life years gain compared to the non-almond strategy in the base-case model. The annual net monetary benefit of almond consumption was $1421 higher per person than no almond consumption, when the willingness to pay threshold was set at $50,000 for annual health care expenditure. Almond was more cost-effective than non-almond in cardiovascular disease prevention in all the sensitivity analyses.
Consuming 42.5 g of almonds per day is a cost-effective approach to prevent cardiovascular disease in the short term and potentially in the long term.
心脏病是美国的主要死因。美国食品和药物管理局批准了一项健康声明，即食用 1.5 盎司（42.5 克）的坚果可降低心血管疾病的风险。先前的研究侧重于其他食物或饮食因素对预防主要心血管疾病的成本效益，而不是杏仁的消费。本研究旨在探讨预防心血管疾病的杏仁消费的成本效益。
本研究从美国医疗保健部门的角度评估了每天食用 42.5 克杏仁的成本效益。
为每天食用 42.5 克杏仁与不食用杏仁以及美国的心血管疾病开发了一个决策模型。
模型中的参数来自文献，包括增加低密度脂蛋白胆固醇的概率、发生急性心肌梗死和中风的概率、治疗急性心肌梗死的概率、死于疾病和手术的概率，以及美国人群中疾病和程序的成本，以及调整后的生命质量。杏仁的成本基于美国市场的当前价格。进行了不同支付意愿水平、概率敏感性分析、十年风险预防、不同程序和杏仁价格成本以及有或没有心血管疾病的患者的敏感性分析。
在基础模型中，杏仁策略的成本比非杏仁策略低 363 美元，质量调整生命年增加 0.02。当支付意愿阈值设定为每年 50000 美元的年度医疗保健支出时，杏仁的年净货币效益比不食用杏仁的年净货币效益高 1421 美元。在所有敏感性分析中，杏仁在预防心血管疾病方面比非杏仁更具成本效益。
每天食用 42.5 克杏仁是一种预防心血管疾病的短期和潜在长期的经济有效的方法。
