Dataset Information

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

ABSTRACT:

Objective

This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases.

Methods

We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars.

Primary and secondary outcomes

The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted.

Results

Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3?years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness.

Conclusions

IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health.

SUBMITTER: Marseille E

PROVIDER: S-EPMC4078786 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

Marseille Elliot E Jiwani Aliya A Raut Abhishek A Verguet Stéphane S Walson Judd J Kahn James G JG

BMJ open 20140626 6

<h4>Objective</h4>This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases.<h4>Methods</h4>We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets fo ...[more]

PMID: 24969782

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Dataset Information

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

Objective

Methods

Primary and secondary outcomes

Results

Conclusions

Publications

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

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