Accounting for the cost of scaling‐up health interventions

Johns, Benjamin; Baltussen, Rob

doi:10.1002/hec.880

Cited by 50 publications

(50 citation statements)

References 15 publications

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“…We based drug costs on the latest WHO negotiated prices, with a mark-up for international and local transportation costs 24 25. Unit costs of health centre visits and hospital inpatient days were taken from Adam et al,26 while those for laboratory tests and x rays were based on the best available international cost information included in WHO's costing database.…”

Section: Methodsmentioning

confidence: 99%

Cost effectiveness analysis of strategies for tuberculosis control in developing countries

Baltussen¹,

Floyd

Dye

2005

BMJ

Self Cite

116

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Objective To assess the costs and health effects of tuberculosis control interventions in Africa and South East Asia in the context of the millennium development goals. Design Cost effectiveness analysis based on an epidemiological model. Setting Analyses undertaken for two regions classified by WHO according to their epidemiological grouping-Afr-E, countries in sub-Saharan Africa with very high adult and high child mortality, and Sear-D, countries in South East Asia with high adult and high child mortality. Data sources Published studies, costing databases, expert opinion. Main outcome measures Costs per disability adjusted life year (DALY) averted in 2000 international dollars ($Int).Results Treatment of new cases of smear-positive tuberculosis in DOTS programmes cost $Int6-8 per DALY averted in Afr-E and $Int7 per DALY averted in Sear-D at coverage levels of 50-95%. In Afr-E, adding treatment of smear-negative and extra-pulmonary cases at a coverage level of 95% cost $Int95 per DALY averted; the addition of DOTS-Plus treatment for multidrug resistant cases cost $Int123. In Sear-D, these costs were $Int52 and $Int226, respectively. The full combination of interventions could reduce prevalence and mortality by over 50% in Sear-D between 1990 and 2010, and by almost 50% between 2000 and 2010 in Afr-E. Conclusions DOTS treatment of new smear-positive cases is the first priority in tuberculosis control, including in countries with high HIV prevalence. DOTS treatment of smear-negative and extra-pulmonary cases and DOTS-Plus treatment of multidrug resistant cases are also highly cost effective. To achieve the millennium development goal for tuberculosis control, substantial extra investment is needed to increase case finding and implement interventions on a wider scale.

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Section: Methodsmentioning

confidence: 99%

Cost effectiveness analysis of strategies for tuberculosis control in developing countries

Baltussen¹,

Floyd

Dye

2005

BMJ

Self Cite

116

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“…Distribution costs —We assumed distribution costs to be most sensitive to changes in coverage levels and calculated them with a standard mark-up based on the average of free on board; cost, insurance, and freight; and additional trade related distributional costs 15 16…”

Section: Methodsmentioning

confidence: 99%

Cost effectiveness analysis of strategies to combat malaria in developing countries

Morel

Lauer

Evans

2005

BMJ

171

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Objective To determine the cost effectiveness of selected malaria control interventions in the context of reaching the millennium development goals for malaria. Design Generalised cost effectiveness analysis. Data sources Efficacy data came from the literature and authors' calculations supported by expert opinion. Quantities for resource inputs came from the literature and from expert opinion; prices came from the WHO-CHOICE database. Methods Costs were assessed in year 2000 international dollars, and effects were assessed as disability adjusted life years averted by a 10 year implementation programme. Analysis was restricted to sub-Saharan regions where the most deadly form of malaria, Plasmodium falciparum, is most prevalent. The impact on population health for various interventions, and their combinations, was evaluated at selected coverage levels by using a state-transition model. Sensitivity analysis was done for age weights and discounting. Results High coverage with artemisinin based combination treatments was found to be the most cost effective strategy for control of malaria in most countries in sub-Saharan Africa. Conclusions A much larger infusion of resources than those currently available is needed to make headway in the fight to roll back malaria. On cost effectiveness grounds, in most areas in sub-Saharan Africa greater coverage with highly effective combination treatments should be the cornerstone of malaria control. However, treatment alone can achieve less than half the total benefit obtainable through a combination of interventions-scaling up the use of impregnated mosquito nets or indoor spraying with insecticides is also critical. Intermittent presumptive treatment of pregnant women can bring a small but important additional health gain at relatively low cost.

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“…For goods available only locally (human resources, inpatient bed days, etc) unit costs vary substantially within countries. We therefore ran cross country regressions using the collected data to estimate the average cost (with adjustments for use of capacity) for each setting 11 – 13 18…”

Section: Classification and Measurement Of Costsmentioning

confidence: 99%

Methods to assess the costs and health effects of interventions for improving health in developing countries

Evans

Edejer²,

Adam³

et al. 2005

BMJ

115

123

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Accounting for the cost of scaling‐up health interventions

Cited by 50 publications

References 15 publications

Cost effectiveness analysis of strategies for tuberculosis control in developing countries

Cost effectiveness analysis of strategies for tuberculosis control in developing countries

Cost effectiveness analysis of strategies to combat malaria in developing countries

Methods to assess the costs and health effects of interventions for improving health in developing countries

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