TRANSLATING REAL‑WORLD HEALTH SYSTEM STRENGTHENING DATA INTO LONG‑TERM CARDIOVASCULAR OUTCOMES: A MODELING FRAMEWORK FROM VIETNAM
Author(s)
Romesh Wiss, MS1, Isabelle Lindenmayer, MS, BS2, Ioana Ursu, MPharm, MSc3.
1Novartis Pharma AG, Basel, Switzerland, 2Novartis Pharmaceuticals Corporation, New York, NY, USA, 3Novartis Pharmaceuticals Ltd, London, United Kingdom.
1Novartis Pharma AG, Basel, Switzerland, 2Novartis Pharmaceuticals Corporation, New York, NY, USA, 3Novartis Pharmaceuticals Ltd, London, United Kingdom.
OBJECTIVES: Low‑ and middle‑income countries (LMICs) face a growing burden of non‑communicable diseases (NCDs) alongside persistent infectious diseases, increasing pressure on health systems. Health system strengthening (HSS) programmes are often evaluated using activity‑based metrics, limiting their influence on policy and resourcing decisions. This study aimed to develop an outcome‑focused health‑economic modeling approach that translates real‑world HSS implementation data into long‑term health and economic outcomes, using a large‑scale cardiovascular disease (CVD) programme in rural Vietnam as a case study.
METHODS: Cùng Sống Khỏe (CSK) is a large‑scale HSS programme implemented in rural Vietnam to strengthen primary care for CVD prevention and treatment. Interventions include community‑based screening, improved referral pathways, patient and provider education, and structured patient follow‑up. A health‑economic Markov model was developed to project long‑term population‑level outcomes by linking pre- and post-intervention observations in risk‑factor control to transitions across CVD health states. Model outcomes included CVD‑related deaths, disability‑adjusted life years (DALYs), non‑fatal CVD events, and healthcare costs over a 10‑year time horizon.
RESULTS: CSK screened 389,316 individuals and linked 36,896 patients to treatment. From pre‑ to post‑intervention, hypertension control improved from 32% to 67% and glycaemic control from 27% to 77%. Over 10 years, the model projected 5,042 CVD‑related deaths averted (30% reduction), 65,991 DALYs averted (27% reduction), 378 non‑fatal CVD events avoided (7% reduction), and healthcare cost savings of US$4.8 million (11% reduction) compared with baseline practice.
CONCLUSIONS: Outcome‑focused economic evaluation of real‑world HSS programmes can generate evidence that is more informative for decision-making than activity‑based metrics. By linking routinely collected implementation data to downstream outcomes, this modelling approach provides a structured framework that can be adapted to other LMIC settings to support transferable assessments.
METHODS: Cùng Sống Khỏe (CSK) is a large‑scale HSS programme implemented in rural Vietnam to strengthen primary care for CVD prevention and treatment. Interventions include community‑based screening, improved referral pathways, patient and provider education, and structured patient follow‑up. A health‑economic Markov model was developed to project long‑term population‑level outcomes by linking pre- and post-intervention observations in risk‑factor control to transitions across CVD health states. Model outcomes included CVD‑related deaths, disability‑adjusted life years (DALYs), non‑fatal CVD events, and healthcare costs over a 10‑year time horizon.
RESULTS: CSK screened 389,316 individuals and linked 36,896 patients to treatment. From pre‑ to post‑intervention, hypertension control improved from 32% to 67% and glycaemic control from 27% to 77%. Over 10 years, the model projected 5,042 CVD‑related deaths averted (30% reduction), 65,991 DALYs averted (27% reduction), 378 non‑fatal CVD events avoided (7% reduction), and healthcare cost savings of US$4.8 million (11% reduction) compared with baseline practice.
CONCLUSIONS: Outcome‑focused economic evaluation of real‑world HSS programmes can generate evidence that is more informative for decision-making than activity‑based metrics. By linking routinely collected implementation data to downstream outcomes, this modelling approach provides a structured framework that can be adapted to other LMIC settings to support transferable assessments.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE81
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)