One fourth of patients with cardiovascular disease near Addis Abeba in Ethiopia use more than 10 % of the households’ income on treatment. Mieraf Taddesse Tolla‘s PhD thesis could help Ethiopia reduce the growing burden of cardiovascular disease.


  1. Focus on primary prevention is the more cost-effective strategy for reducing the burden of cardiovascular disease in Ethiopia.
  2. Cardiovascular disease leads to a catastrophic economic burden for more than one fourth of Ethiopian patients.


Thesis: Prevention and treatment of cardiovascular disease in Ethiopia saves more than lives: cost-effectiveness analysis, extended cost-effectiveness analysis, and financial risk protection
Candidate: Mieraf Taddesse Tolla
Time: February 9, 2018 at 12:15
Place: Haukeland University Hospital, Armauer Hansens House: Auditorium
Link to university website (in Norwegian)


(1) The most cost-effective intervention for prevention and control of cardiovascular disease in Ethiopia is a combination drug treatment for individuals with a perceived risk of 35 % or more. Offering a package consisting of blood pressure and cholesterol-lowering medications to these high-risk individuals seems to be the most cost-effective strategy. Taddesse Tolla and co-workers suggest that people with lower risk could be included when Ethiopia’s health budget increases. Primary prevention should be proritized over secondary prevention until more resources are available. 

(2) More than one fourth of Ethiopians who receive treatment for cardiovascular disease use more than 10 % of their households’ income on treatment. Patients with the lowest income face an almost 60-fold greater risk of such catastrophic health expenditure compared to the fifth with the highest income. 589 patients living in or near the capital Addis Ababa were included in the study in 2015.


(1) Tolla, M. T., Norheim, O. F., Memirie, S. T., Abdisa, S. G., Ababulgu, A., Jerene, D., Bertram, M., Strand, K., Verguet, S., & Johansson, K. A. (2016). Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysisCost Effectiveness and Resource Allocation14(1), 10.

(2) Tolla, M. T., Norheim, O. F., Verguet, S., Bekele, A., Amenu, K., Abdisa, S. G., & Johansson, K. A. (2017). Out-of-pocket expenditures for prevention and treatment of cardiovascular disease in general and specialised cardiac hospitals in Addis Ababa, Ethiopia: a cross-sectional cohort studyBMJ Global Health2(2), e000280.

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