| 1. Epidemiology |
| Prevalence of hypertension, mortality estimates, probabilities of incidence of CVD, diabetes, incidence of related complications | - Prevalence of hypertension from Ghana Statistical Service & DHS Census Data (2012, 2014) | - 2014 Ghana DHS included measurement of blood pressure for a representative sample of the population |
| - Mortality rates from WHO estimated life table for Ghana | - Preferable to use estimates of incidence of adverse events from Ghana but not able to identify good quality local cohort studies with longitudinal follow-up |
| - Annual probabilities of incidence of CVD + diabetes from international literature |
| - Baseline estimates of the incidence of CVD from multivariate analysis of primary care data, black African patients in the United Kingdom (QRisk2 algorithm) |
| 2 Clinical efficacy |
| Effectiveness of AHM; incidence of adverse events | NICE model | - Good evidence that the effects of the main classes of antihypertensive drugs vary by ethnicity |
| Meta-analyses from international literature for black African population (not specifically Ghanaian) |
| - Estimates of adverse events were not available from any West population cohort |
| 3 Cost |
| Antihypertensive medicines, interactions with the health system | - Unit costs of service from NHIS price for drugs on the essential medicines list, NHIS tariffs | - NHIS tariffs are updated annually but may not be publicly available |
| - Daily dose and healthcare intervention assumptions from recommendations in Ghana Standard Treatment Guidelines for hypertension | - Some data not available by brand or formulation |
| - Costs to other healthcare insurers, OOPE and the value of lost production due to ill-health or use of healthcare were not included in the model |
| 4 Service use |
| Health services and events, treatment of adverse events | - NHIS protocols | - NHIS data is restricted access |
| - Expert opinion | - 30% data are available electronically |
| 5 Quality of life |
| DALYs, disability weights | 2004 GBD study | - Ghana burden of disease study to validate GBD data |
| - More recent summary estimates were not available for the conditions of interest (stroke, CHD, diabetes and heart failure) |
| 6 Equity |
| Impact of geography, gender, socioeconomic status, or other differentiating factors on health outcomes | Not considered in the pilot | Results could be disaggregated by geography; urban/rural using DHS data in future analyses |
