Cost-effectiveness of milk powder fortified with potassium to decrease blood pressure and prevent cardiovascular events among the adult population in China: a Markov model

Abstract

ObjectiveTo model the long-term cost-effectiveness of consuming milk powder fortified with potassium to decrease systolic blood pressure (SBP) and prevent cardiovascular events.DesignA best case scenario analysis using a Markov model was conducted.Participants8.67% of 50–79 year olds who regularly consume milk in China, including individuals with and without a prior diagnosis of hypertension.InterventionThe model simulated the potential impact of a daily intake of two servings of milk powder fortified with potassium (+700 mg/day) vs the consumption of a milk powder without potassium fortification, assuming a market price equal to 0.99 international dollars (intl$; the consumption of a milk powder without potassium fortification, assuming a market price equal to intl$0.99 for the latter and to intl$1.12 for the first (+13.13%). Both deterministic and probabilistic sensitivity analyses were conducted to test the robustness of the results.Main outcome measuresEstimates of the incidence of cardiovascular events and subsequent mortality in China were derived from the literature as well as the effect of increasing potassium intake on blood pressure. The incremental cost-effectiveness ratio (ICER) was used to determine the cost-effectiveness of a milk powder fortified with potassium taking into consideration the direct medical costs associated with the cardiovascular events, loss of working days and health utilities impact.ResultsWith an ICER equal to int$4711.56 per QALY (quality-adjusted life year) in the best case scenario and assuming 100% compliance, the daily consumption of a milk powder fortified with potassium shown to be a cost-effective approach to decrease SBP and reduce cardiovascular events in China. Healthcare savings due to prevention would amount to intl$8.41 billion. Sensitivity analyses showed the robustness of the results.ConclusionTogether with other preventive interventions, the consumption of a milk powder fortified with potassium could represent a cost-effective strategy to attenuate the rapid rise in cardiovascular burden among the 50–79 year olds who regularly consume milk in China.

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

“…Findings from other countries have provided overall positive results, suggesting that nutrition interventions, together with other strategies, such as early diagnosis and national hypertension treatment programs could be valid allies in fighting NCDs [115,116]. For example, two recent studies from China, a country geographically proximal to Malaysia, one study evaluating an educational program to lower salt intake of schoolchildren’s families in an urban area [27], and one study modeling the long-term cost-effectiveness of milk powder fortified with potassium for the 50–79-year-olds who regularly consume milk [51], proved the cost-effectiveness of the interventions. Different from those studies, which targeted only SBP as a risk factor (either through a reduction of the salt intake [27] or an increment in the consumption of potassium [51]), this study evaluated the effect of potassium and phytosterols together to focus on SBP and cholesterol.…”

“…Similarly, to estimate the 28-day mortality rate due to stroke for both the well and the chronic CVD population we relied on an average of the probabilities stratified according to stroke typology (ischemic, intracerebral hemorrhagic, and subarachnoid hemorrhagic) weighted by their relative frequency [33]. To differentiate the mortality rates according to age, we adopted the approach used in Dainelli et al [51]: annual increases in mortality rates were computed by subtracting the 28-day to the 1-year survival probability estimates and then averaged according to their relative frequencies. The same increase was adopted for 5-year age cohorts by applying the following formula:Pt=P0(1+annual rate)t where P 0 is the baseline probability and t indicates the difference in years from the occurrence of the first-ever stroke.…”

Healthy ageing: the natural consequences of good nutrition—a conference report

“…Another example examined new food products and their impact on health outcomes, such as blood pressure and cardiovascular events, by assessing individual data on food consumption combined with intake models. This study by Dainelli et al [ 31 ] looked at the shift in intakes of potassium-fortified milk powder and consecutively the health impact via replacing milk consumption with the fortified product in adults above the age of 45.…”

A big appetite for data

“…One such study [2] investigated the impact of a new milk powder in China, a country where the burden of cardiovascular disease is on the incline. Potassium has been shown to reduce systolic blood pressure in pre‐hypertensive consumers.…”