Bulletin of the World Health Organization

Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles

Roger Ndindjock, Jude Gedeon, Shanthi Mendis, Fred Paccaud & Pascal Bovet

Volume 89, Number 4, April 2011, 286-295

Table 6. Cost-effectivenessa of various cardiovascular (CV) risk management strategies in people aged 40–64 years, Seychelles, 2004

Management strategy People to treatb CV events avertedb NNTc Medication cost
Seychelles (2004 US$)
India (2005 US$)
Annually (millions) Per CV event averted Annually (millions) Per CV event averted
Single-risk-factor
BP ≥ 140/90 mmHg 44 899 127 354 3.25 25 679 1.84 14 534
TSC ≥ 6.2 mmol/l 28 317 39 727 15.09 387 275 1.24 31 831
BP ≥ 140/90 mmHg or TSC ≥ 6.2 mmol/l 59 741 157 379 25.27 160 452 3.89 24 678
Total CV risk
CV risk ≥ 10% 10 837 137 79 NAd NA 1.03 7 499
CV risk ≥ 20% 5 114 92 56 NA NA 0.49 5 291
CV risk ≥ 20% or BP ≥ 160/100 mmHg or TSC ≥ 8.0 mmol/l 20 653 147 140 NA NA 1.96 13 307
Current situation 37 667 103 366 15.93 154 674 2.45 23 789

BP, blood pressure; NNT, number needed to treat; TSC, total serum cholesterol; US$, United States dollars.

a All cost and cost-effectiveness estimates are based on the prices of medications only and on the assumptions that all persons in the population who have a specified condition are known and that adherence to treatment is 100%.

b Annually per 100 000 people aged 40–64 years. For “people to treat” the figures correspond to the prevalences of the specified conditions per 100 000 people.

c Number of persons aged 40–64 years that one would need to treat annually (per 100 000) to avoid one fatal or non-fatal CV event.

d Not applicable since the polypill is not yet available in Seychelles.