Fig 1.
Poverty head count ratio and poverty gap before and after medicine purchase.
Table 1.
Per capita expenditure distribution for rural and urban India according to cumulative percentage of the population.
Table 2.
Common drugs for cardiovascular disease prevention in the national essential medicines list and their prices.
Table 3.
Cost-effectiveness of cardiovascular medicines for primary prevention of Ischemic Heart Disease.
Table 4.
Cardiovascular disease primary and secondary prevention step-up regimens with their prices.
Fig 2.
Expenditure curves for rural India before and after medicine purchase.
Fig 3.
Expenditure curves for urban India before and after medicine purchase.
Table 5.
Poverty ratio and poverty gap index for rural and urban India before and after medication purchase, calculated by using aggregate data.
Table 6.
Rural and Urban poverty ratio for India calculated with aggregate and micro data and the difference between the two, before and after medicine purchase.
Fig 4.
Schematic representation of the percentage of urban adults in primary prevention regimens.
Note: Our assumptions, based on clinical recommendations, are as follows: 1. All adults with high short term risk of CVD require at least an aspirin. All adults with stage 1 hypertension (BP 140-159/90-99) require treatment with 1 anti-hypertensive medication and an aspirin. All adults with stage 2 hypertension require 2 anti-hypertensive medications and aspirin. We also assume that all adults with a single lipid disorder require treatment with low dose statin and all adults with more than one lipid disorder require treatment with high dose statin. The following estimates are used in our calculations, and they are based on published studies: percentage of urban adults with high short-term risk is 21.8%. Among these, percentage of adults with hypertension is 53%. Percentage of hypertensive adults with stage 1 hypertension is 70%. Percentage of hypertensive adults with both hypertension and hyperlipidemia is 30%. Among these hypertensive-hyperlipidemic adults, percentage of adults with single lipid disorder is 64% and more than one lipid disorder is 36%. The same percentages apply for rural adults, except that the percentage of rural adults with high short-term risk of cardiovascular disease is 12%.
Table 7.
Estimates of the number of people that could benefit from cardiovascular medicines and the resulting number of people financially burdened or impoverished due to medication purchase.
Fig 5.
Univariate sensitivity analysis showing the change in the number of rural and urban adults impoverished with a 10% change in each of the variables that determine the potential user population.