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This model begins by assuming that program participants would receive the treatment and benefit from it for the rest of their lives, then divides by the number of treatment-years to get the annual benefit.
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A key assumption underlying this model is that the benefits of salt substitution are mediated solely by blood pressure reduction. This may not be the case.
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Mortality
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Percent of deaths in low-SDI countries attributed to cardiovascular disease16.13%
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Percent of deaths in low-mid-SDI countries attributed to cardiovascular disease27.51%
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Percent of deaths in mid-SDI countries attributed to cardiovascular disease37.33%
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Average percent of deaths attributed to cardiovascular disease across low-, low-mid-, and mid-SDI countries26.99%
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Average systolic BP reduction from community-based salt substitution intervention, mm Hg1.23
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Relative risk of cardiovascular death from a 10 mm Hg reduction in systolic BP0.80
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Percent reduction in cardiovascular death risk due to salt substitution2.5%
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Lifetime cardiovascular deaths in a cohort of 100,00026990
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Lifetime cardiovascular deaths prevented by lifelong salt substitution in a cohort of 100,000664
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Average age across low-, low-mid, and mid-SDI countries29.6
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Life expectancy at age 29.6 in low-SDI countries44.48
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Life expectancy at age 29.6 in low-mid-SDI countries45.8
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Life expectancy at age 29.6 in mid-SDI countries49.4
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Life expectancy at age 29.6 across low-, low-mid, and mid-SDI countries46.6
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Annual deaths prevented by salt substitution intervention in a cohort of 100,00014.3
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Internal validity adjustment1.0
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External validity adjustment1.0
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Coverage adjustment for education interventions0.45
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Moral value of averting one middle-age death54.8
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Units of value from treating 100,000 people for one year781
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Morbidity
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Ratio of cardiovascular YLDs to deaths in LMICs1.79
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Cardiovascular YLDs averted by salt substitution intervention25.52
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Moral value of averting one YLD2.3
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Units of value from treating 100,000 people for one year59
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Costs
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Cost of salt substitute per kg, USD$0.65
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Total salt consumed per person, per year3.65
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Percent of salt replaced75%
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Cost of salt substitute consumed per 100,000, per year$177,937.50
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Annual operating costs per program participant$2.59
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Operating costs per 100,000, per year$259,000.00
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Cost of salt substitute plus operating costs, per 100,000, per year$436,937.50
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Annual per-participant cost of health education $1.31
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Cost of intervention per 100,000, per year$131,000.00
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Results
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Cost assumption: charity distributes salt substitute and bears its full cost
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Units of value per $100,000 donation, salt substitute192
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Units of value per $100,000 donation, GiveDirectly344
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Cost-effectiveness of salt substitute, multiples of cash0.6
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Cost of averting one death$30,644.78
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Cost per outcome as good as averting one under-5 death$60,803.75
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Cost assumption: charity distributes salt substitute and bears half its cost
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Units of value per $100,000 donation, salt substitute241
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Units of value per $100,000 donation, GiveDirectly344
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Cost-effectiveness of salt substitute, multiples of cash0.7
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Cost of averting one death$24,404.92
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Cost per outcome as good as averting one under-5 death$48,422.96
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Cost assumption: consumers bear full cost of salt replacement; charity only pays for health education
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Units of value per $100,000 donation, salt substitute287
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Units of value per $100,000 donation, GiveDirectly344
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Cost-effectiveness of salt substitute, multiples of cash0.8
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Cost of averting one death$20,551.51
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Cost per outcome as good as averting one under-5 death$40,777.23
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