Technical characteristics of included studies and quality grading (strength of evidence)
| Source (author, year) | Institution(s) conducting the study | Funding agency | Currency, year | Choice of decision model and key parameters | Time horizon | Discount rate used | Incremental analysis reported | SeA done | Quality grading† (++, +, −) |
| Turi et al, 199153 | Nizam’s Institute of Medical Sciences Hyderabad, India | Not stated | US$, 1988 | Cost comparison/consequences analysis | NA | NA | NA | NA | − |
| Ahuja et al, 199754 | King George’s Medical College, Lucknow, India | Not stated | Rupee, 1997 | RCT-based CEA | 6 months | NA | Yes | No | + |
| Nanjappa et al, 199855 | Sri Jayadeva Institute of Cardiology, Bangalore, India | Not stated | US$, 1996 | Cost comparison/consequences analysis | NA | NA | NA | NA | − |
| Malhotra et al, 200156 | Nehru Hospital, Chandigarh, India | Not stated | Rupee and US$, 1999 | RCT-based CEA | Hospital admission until discharge (5–7 days) | NA | Yes | No | + |
| Murray et al, 200357 | WHO-CHOICE | Not stated | Int$, 2000 | Standard multistate transition model tool with four states: PopMod was used to calculate DALY averted by reducing CVD risk | Lifetime | 3% for both costs and effects | Yes | Yes | ++ |
| Chisholm et al, 200415 | WHO-CHOICE; University of Queensland, Australia; Centre for Addiction and Mental Health, Toronto, Canada | Not stated | Int$, 2004 | Static State Transition decision model (generalised CEA) | Not stated (assume: lifetime) | 3% for both costs and effects | Yes | Yes | + |
| Namboodiri et al, 200458 | PGIMER, Chandigarh, India | Not stated | Rupee, 2001 | Cost comparison/consequences analysis | NA | NA | NA | NA | − |
| Narayan et al, 200634 | DCP2 Chapter | Fogarty International Centre NIH, BMGF, WHO, World Bank | US$, 2001 | Cost-utility and cost-effectiveness analyses were based on published literature models; costs estimated from WHO-CHOICE resource | Not stated (assume: lifetime) | Not stated | Yes | Not stated | + |
| Gaziano et al, 200643 | DCP2 Chapter | Fogarty International Centre NIH, BMGF, WHO, World Bank | US$, 2001 | Population-based decision model; DALY weights taken from Mathers (2006)79 and costs data from McFayden (2003)80 | Not stated (assume: lifetime) | Not stated | Yes | Not stated | + |
| Willett et al, 20065 | DCP2 Chapter | Fogarty International Centre NIH, BMGF, WHO, World Bank | US$, 2001 | Population-based decision model; authors have used local costs data and interventions benefits from published literature sources | Not stated (assume: lifetime) | Not stated | Yes | Not stated | + |
| Rodgers et al, 200659 | DCP2 Chapter | Fogarty International Centre NIH, BMGF, WHO, World Bank | US$, 2001 | Population-based decision model; authors have used local costs data and interventions benefits from published literature sources | Not stated (assume: lifetime) | Not stated | Yes | Not stated | + |
| Jha et al, 200660 | DCP2 Chapter | Fogarty International Centre NIH, BMGF, WHO, World Bank | US$, 2002 | Population-based decision model; authors have used local costs data and interventions benefits from published literature sources | Not stated (assume: lifetime) | Not stated | Yes | Not stated | + |
| Shafiq et al, 200661 | PGIMER Chandigarh, India | Not stated | US$ and rupee, 2004 | RCT-based CEA | Within trial analysis (30-day follow-up) | NA | Yes | + | |
| Ramachandran et al, 200737 | IDRF, Chennai, India | Not stated | Rupee and US$, 2006 | RCT-based CEA | Within trial analysis (3 years) | No discounting | Yes | Yes | ++ |
| Zubair Tahir et al, 200962 | Aga Khan University Hospital, Karachi, Pakistan | Not stated | US$, 2007 | Cost comparison/consequences analysis | NA | NA | NA | NA | − |
| Habib et al, 201063 | Health Economics Unit, Diabetic Association of Bangladesh | None | US$ (year not stated) | Retrospective hospital medical records-based economic analysis | NA | NA | No | NA | − |
| Habib et al, 201064 | Health Economics Unit, Diabetic Association of Bangladesh | None | US$ (year not stated) | Retrospective hospital medical records-based economic analysis | NA | NA | No | NA | − |
| Sanmukhani et al, 201065 | Government Medical College, Gujarat, India; Postgraduate Institute of Medical Education and Research, Chandigarh, India | Cadila Pharmaceutical, Ahmedabad, Gujarat, India | Rupee, 2010 | Published RCTs-based CEA | Not clear (variable as per the RCT selected for the CEA) | Not clear | Yes | No | + |
| Cecchini et al, 201032 | WHO-CHOICE; University of Queensland, Australia; Economic Analysis Unit, Mexico | None | US$, 2005 | Chronic disease prevention model—microsimulation | 50 years and lifetime horizon | 3% for both costs and effects | Yes | Yes | ++ |
| Schulman-Marcus et al, 201040 | AIIMS, New Delhi; HSPH, New York | Sarnoff Cardiovascular Research Foundation, Fogarty International Centre NIH | US$, 2007 | Markov model of urban Indian patients with acute chest pain presenting to a GP performing an ECG vs not performing one | Lifetime | 3% for both costs and effects | Yes | Yes | ++ |
| Donaldson et al, 201130 | PHFI and Johns Hopkins Bloomberg School of Public Health, Baltimore, USA | None | US$, 2008 | Details of model structure not provided, but assumptions and key parameters listed | 10 years and lifetime | 3% for both costs and effects | Yes | Yes | ++ |
| Lohse et al, 201166 | Novo Nordisk Denmark and UCSF | Novo Nordisk A/S. | US$, 2011 | GDModel decision tree | Lifetime | 3% per year for costs; effects not discounted, neither justified | Yes | Yes | + |
| Jafar et al, 201136 | AKU, Karachi, ICL, LSHTM | Wellcome Trust award | US$, 2007 | RCT-based CEA; benefits seen in BP reduction was converted to CV DALYs, using data from GBD study and using a linear regression model | 10, 20, 50 years and lifetime | 5% for both costs and effects | Yes | Yes | ++ |
| Ahmad et al, 201167 | MGMC-Sitapura, Jaipur | Not stated | US$, 2010 | Observational study | NA | NA | Yes | No | + |
| Humaira et al, 201268 | Department of Ophthalmology, BADAS, Bangladesh | None | US$ (year not stated) | Retrospective hospital medical records-based economic analysis | NA | NA | No | NA | − |
| Brown et al, 201331 | University of Texas, Public Health Foundation of India | NIH grant | US$, 2006 | RCT-based CEA and Markov model for long term cost-effectiveness | Lifetime, within trial | No | Yes | Yes | + |
| Ortegón et al, 201229 | University of Columbia, University of Washington, WHO | None | Int$, 2005 | Chronic disease prevention model—WHO software DisMod II | Lifetime | 3% for both costs and effects | Yes | Yes | + |
| Marseille et al, 201335 | Chennai Corporation Maternity Hospital referred GDM cases to Diabetes Care and Research Institute for antenatal monitoring and treatment | Novo Nordisk A/S | Int$, 2011 | Decision-analysis tool (the GeDiForCE) to assess cost-effectiveness | Lifetime | 3% for both costs and effects | Yes | Yes | + |
| Rachapelle et al, 201327 | Sankara Nethralaya, Vision Research Foundation, Chennai and LSHTM | Sightsavers grant | US$, 2009 | Markov model (TreeAge Pro 2009) | 20 years, lifetime | 3% for costs | Yes | Yes | + |
| Megiddo et al, 201438 | Centre for Disease Dynamics, Economics, and Policy, Washington, DC, USA; Public Health Foundation of India, New Delhi, India | Bill and Melinda Gates Foundation (Disease Control Priorities 3 Project) | US$, 2014 | CHD cohort model | Lifetime | 3% | Yes | Yes | ++ |
| Patel et al, 201469 | Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India; UN Mehta Institute of Cardiology and Research Centre, Ahmedabad, India; BJ Medical College, Ahmedabad, Gujarat, India | None | Rupee, 2007 | RCT-based CEA | Within trial analysis (8 weeks) | No discounting | No | No | + |
| Lamy et al, 201470 | McMaster University, Canada; AIIMS and Centre for Chronic Disease Control, New Delhi, India | Sanofi Aventis, Paris, France | US$, 2014 | Randomised trial-based cost-minimisation analysis | 6.2 years—median trial duration | 3% for costs | Yes | Yes | ++ |
| Lamy et al, 201471 | McMaster University, Canada; University of Oxford, UK; AIIMS and Centre for Chronic Disease Control, New Delhi, India; Charles University, Prague, Czech Republic; Ankara University School of Medicine, Ankara, Turkey; and Unidade de Terapia Intensiva, Hospital do Coracao, Sao Paulo, Brazil | Canadian Institutes of Health Research grant | US$, 2013 | Randomised trial-based cost-minimisation analysis | 1 year | Not applicable | Yes | Yes | ++ |
| Anchala, et al, 201572 | Public Health Foundation of India, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India; University of Cambridge, UK; Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands | Wellcome Trust Capacity Strengthening Strategic Award to the Public Health Foundation of India and a consortium of UK universities | Rupee and US$ | RCT-based CEA | 1 year | 3% for costs | No | Yes | + |
| Dukpa et al, 201573 | Ministry of Health, Royal Government of Bhutan Health Intervention and Technology Assessment Program; Ministry of Public Health, Thailand; Mahidol University, Bangkok, Thailand | The Regional Office for South-East Asia of the WHO | Bhutanese ngultrum, 2013 | Markov model | Lifetime | 3% for costs and effects | Yes | Yes | ++ |
| Basu et al, 201539 | Stanford University, USA; London School of Hygiene and Tropical Medicine, London, UK; University of Southern California, USA; National Bureau of Economic Research, Cambridge, Massachusetts, USA | The World Bank, Rosenkranz Prize for Healthcare Research | US$, 2014 | Microsimulation model of myocardial infarction and stroke in India | 20 years | 3% for costs and effects | Yes | Yes | ++ |
| Basu et al, 201574 | Stanford University, USA; London School of Hygiene and Tropical Medicine, London, UK; Imperial College London, London, UK; Public Health Foundation of India; Veterans Affairs Hospital, Ann Arbor, Michigan, USA; University of Michigan, USA; University College London, London, UK | Various federal funding support* | US$, 2014 | Microsimulation model | 10-year implementation horizon | 3% for costs | No | Yes | ++ |
| Gupta et al, 201541 | Jaslok Hospital and Research Centre, Mumbai, India; Pharmacoeconomics Centre of KSMC, Riyadh, Saudi Arabia; Novo Nordisk A/S, Søborg, Denmark; Universiti Sains Malaysia, Penang, Malaysia | Novo Nordisk | US$, 2013 Rupee, 2013 | IMS CORE Diabetes Model | 1-year, 30-year time horizon | 3% for costs and effect measures | Yes | Yes | ++ |
| Home et al, 201575 | Newcastle University, Newcastle on Tyne, UK; University Guro Hospital, Seoul, South Korea; Instituto Jalisciense de Investigacion en Diabetes y Obesidad, Guadalajara, Mexico; Internal Medicine Department, University Hospital Setif, Setif, Algeria; Market Access – Value Communication, Novo Nordisk A/S, Søborg, Denmark | Novo Nordisk | US$, 2013 Rupee, 2013 | IMS CORE Diabetes Model | 24-week follow-up 1-year time 30-year time horizon | 3% for costs and effect measures | Yes | Yes | ++ |
| Sengottuvelu et al, 201676 | Apollo Hospitals, Chennai, India | Not stated | Rupee and US$, 2014 | Cost comparison/consequences analysis | NA | NA | NA | NA | − |
| Limaye et al, 201677 | Hochschule Hannover, Hannover, Germany; Institute of Chemical Technology, Mumbai, India | Not stated | Rupee, 2016 | Cross-sectional study-based CEA | No details provided | No discounting | No | No | − |
| Basu et al, 201678 | Stanford University, Stanford, California, USA; Harvard Medical School, Boston, USA; University College London, London, UK; University of Michigan, Ann Arbor, USA; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, USA; Imperial College London, London, UK; Public Health Foundation of India, New Delhi, India | Various federal funding support* | US$, 2015 | Decision modelling-based CEA | Lifetime | 3% for costs and effect measures | Yes | Yes | ++ |
*Various federal funding support—the US National Institutes of Health; the Veterans Affairs Health Services Research and Development Service; the Rosenkranz Prize for Healthcare Research in Developing Countries; the International Development Research Centre of Canada; the NIHR Research Professorship award; and the Wellcome Trust Capacity Strengthening Strategic Award.
†Quality grading: ++ studies meeting all criteria on the checklists used for critical appraisal and provides strong CE evidence on interventions evaluated; + studies that fulfils some of the checklist criteria and provides supportive evidence on CE, which needs to be confirmed by future studies; − studies not meeting most criteria from the checklists used and so the CE estimates are uncertain.
AIIMS, All India Institute of Medical Sciences; AKU, Aga Khan University; BADAS, Bangla Bangladesh Diabetic Somiti (The Diabetic Association of Bangladesh); BMGF, Bill and Melinda Gates Foundation; BP, blood pressure; CE, Cost-effective; CEA, cost-effectiveness analysis; CHD, Coronary Heart Disease; CORE, Centre for Outcomes Research; CV, cardiovascular; CVD, cardiovascular diseases; DALY, disability-adjusted life years; DCP2, Disease Control Priorities-2 book; GBD, Global Burden of Disease; GDM, gestational diabetes mellitus; GP, general practitioner; HSPH, Harvard School of Public Health; ICL, Imperial College London; IDRF, India Diabetes Research Foundation; Int$, international dollar; LSHTM, London School of Hygiene & Tropical Medicine; MGMC, Mahatma Gandhi Medical College; NA, not applicable; NIH, National Institutes of Health; PGIMER, Post Graduate Institute of Medical Education and Research; PHFI, Public Health Foundation of India; RCT, randomised controlled trials; SeA, sensitivity analysis; UCSF, University of California San Francisco; WHO-CHOICE, Choosing Interventions that are Cost-Effective.