Economic evaluation of population‐level dementia prevention strategies in China: informing policy and public health action
Chao Gong, Jiawei Zhang, Naaheed Mukadam, Quan Wang, Zheng Zhu, Yixin Qin, Qi Qin, Kun Yang, Xia Wei, Yi Tang, Li YangAbstract
INTRODUCTION
While it has been postulated that population‐based strategies targeting modifiable dementia risk factors are cost effective in high‐income settings, their health and economic impact in China remains unclear.
METHODS
A Markov model evaluated five interventions: salt substitution, smoke‐free legislation, increased tobacco tax, sugar‐sweetened beverage tax, and alcohol tax. Outcomes included dementia cases, deaths averted, life years gained, and lifetime cost‐savings, assessed from a societal perspective over an infinite time horizon. Subgroup and sensitivity analyses were performed.
RESULTS
All interventions were assessed to be cost‐saving. Salt substitution was modeled to have the greatest impact, resulting in 1,940,000 quality‐adjusted life years gained and lifetime cost savings of US$65 to US$70 billion. Smoke‐free policies and tobacco taxes also showed significant benefits. Beverage and alcohol taxes had smaller but meaningful effects. Males generally benefited more.
DISCUSSION
We estimated that population‐level interventions would reduce costs in China, with the largest gains from targeting hypertension and smoking. Prioritizing such strategies may generate substantial health gains while reducing long‐term societal costs.