Cost-effectiveness analysis of a household salt substitute intervention on reducing community-wide blood pressure in Northern Peru

Abstract

Background: Hypertension is the top risk factor for cardiovascular diseases in low- and middle-income countries. Replacing regular salt with potassium-enriched alternatives is a new strategy in resource-constrained settings, but its economic impact is still underexplored. Methods: We conducted a cost-effectiveness analysis of a complex intervention that includes a salt substitute and a social marketing campaign to promote its adoption at the regional level in the Peruvian region of Tumbes. The present analysis considered a lifetime horizon. Intervention costs were obtained from the trial’s audit, and health outcome costs were sourced from the literature. All costs and DALYs were discounted at a rate of 3%. Results: Over the lifetime horizon, we found that the intervention averted 2.46 and 1.51 cases of hypertension and cardiovascular disease events per 100 persons, respectively. The intervention was dominant (better outcomes at lower costs) than the baseline scenario, considering the number of DALYs averted. Sensitivity analyses showed the robustness of our assumptions. Conclusions: Replacing regular salt with a salt substitute was cost-effective for the Tumbes region.