Table 3 Main assumptions for the cost-effectiveness analysis
Parameters | Estimate (SD or range) | Distribution | Reference |
|---|---|---|---|
Patient characteristics | |||
 Age, y | 60 (7.53) | Normal | CSPPT [6] |
 Male sex，% | 41% | Table | |
Clinical characteristics | |||
 Total cholesterol, mg/dL | 213.6 (46) | Normal | CSPPT [6] |
 HDL-C, mg/dL | 52 (14) | Normal | |
 Baseline SBP, mm Hg | 139.7 (11.1) | Normal | |
 Smoking,% | 23% | Table | |
 Diabetes mellitus,% | 3% | Table | |
Rates and probabilities | |||
 Morbidity rates, annual | |||
 Primary stroke | 1 −  exp [λ ∗ (state)γ − λ ∗ (state + 1)γ] | Weibull | CSPPT [6] |
 Primary CHD | 1 −  exp ((ln(1 − P))/10) P = 1 − S(t)exp(f[x, M]) f(x, M) = β1 ∗ (x1 − M1) + … + βp ∗ (xp − Mp) | / | CMCS [22] |
 Stroke relapse in 1 year | 17% | β | CKB study [23] |
 Stroke relapse after 1 year | 2–9% | β | |
 Stroke after CHD | 0.4% | β | The EUROPA study [24] |
 Stroke after post-CHD | 0.4% | β | |
 CHD relapse in 1 year | 2.5% | β | PEACE [25] |
 CHD relapse after 1 year | 1.2% | β | The EUROPA study [24] |
 CHD after stroke | 0.4% | β | CKB study [23] |
 CHD after post-stroke | 0.4% | β | |
 Mortality rates, annual | |||
 Non CVD related | 1.68–507.28‰ (Age-dependent) | β | Life table [26] |
 After stroke | 15% | β | CKB study [23] |
 After post-stroke | 3% | β | |
 After CHD | 2.8% | β | PEACE [25] |
 After post-CHD | 1.5% | β | The EUROPA study [24] |
Drug cost per unit, $ (ï¿¥) | |||
 Enalapril | $0.09 ($0.03–$0.22) ￥0.56 (￥0.2–￥1.44) | γ | Local bidding Price or the National centralized drug procurement price [27, 28] (see Additional file 1: Table S3) |
 Enalapril-folic acid | $0.74 ￥4.75 | γ | |
 Angiotensin-converting enzyme inhibitors | $0.13 ($0.11–$0.38) ￥0.83 (￥0.72–￥2.43) | γ | |
 Angiotensin II receptor blockers | $0.08 ($0.07–$0.54) ￥0.53 (￥0.48–￥3.48) | γ | |
 Calcium channel blockers | $0.25 ($0.14–$0.47) ￥1.60 (￥0.91–￥3.06) | γ | |
 Diuretics | $0.29 ($0.27–$0.30) ￥1.88 (￥1.72–￥1.95) | γ | |
 β-blockers | $0.03 ($0.02–$0.05) ￥0.21 (￥0.16–￥0.32) | γ | |
 Lipid-lowering drugs | $0.08 ($0.03–$0.65) ￥0.50 (￥0.17–￥4.19) | γ | |
 Glucose-lowering drugs | $0.04 ($0.03–$0.24) ￥0.24 (￥0.19–￥1.57) | γ | |
 Antiplatelet drugs | $0.05 ($0.05–$0.08) ￥0.34 (￥0.31–￥0.50) | γ | |
CVD hospitalization costs, $ (ï¿¥) (first 30 days) | |||
 Ischemic stroke | $1529.18 (± 20%) ￥9863.20 (± 20%) | γ | China’s Health Statistics Yearbook, 2021 [29] |
 Hemorrhagic stroke | $3207.55 (± 20%) ￥20,688.70(± 20%) | γ | |
 Coronary heart disease | $4696.39 (± 20%) ￥30,291.70(± 20%) | γ | |
Rehabilitation costs per month, $ (ï¿¥)a | |||
 Rehabilitation training | $200.93 (± 20%) ￥1296.00 (± 20%) | γ | National Development and Reform Commission [30] (see Additional file 1: Table S4) |
 Rehabilitation checking | $7.91 (± 20%) ￥51.00 (± 20%) | γ | |
 Home care | $465.12 (± 20%) ￥3000.00 (± 20%) | γ | |
Utility | |||
 Pre-CVD | 0.90 (0.12) | β | CSPPT [6] |
 Primary stroke (first year) | 0.76 | β | Du [31] |
 Primary stroke (after first year) | 0.79 | β | |
 Recurrent stroke (first year) | 0.30 | β | Wang [32] |
 Recurrent stroke (after first year) | 0.33 | β | |
 Primary CHD (first year) | 0.77 (0.75–0.78) | β | Goldsmith [33] |
 Primary CHD (after first year) | 0.89 (0.17) | β | Wang [34] |
 Recurrent CHD (first year) | 0.64 | β | Thomas [35] |
 Recurrent CHD (after first year) | 0.76 | β | |
Treatment adherence | |||
 Enalaparil-folic acid | 0.692 (± 20%) | β | CSPPT [6] |
 Enalapril | 0.691 (± 20%) | β | |
HR of primary stroke | 0.79 (0.68 -0.93) | β | |
Disability rate | 0.39 (0.20–0.8)) | β | Salomon [8] |
Rehabilitation rate after stroke | 0.58 (0–0.7) | β | Asakawa [36] |
Annual discount rates for life years, costs, and QALYs | 5% (0–8%) | / | |