Disability-adjusted life years for severe acute malnutrition: implications of alternative model specifications

2019 ◽  
Vol 22 (15) ◽  
pp. 2729-2737 ◽  
Author(s):  
Chloe Puett ◽  
Assaye Bulti ◽  
Mark Myatt
Keyword(s):  
Cost Effectiveness ◽  
Severe Acute Malnutrition ◽  
Secondary Data ◽  
Acute Malnutrition ◽  
Marginal Effect ◽  
Disability Adjusted Life Years ◽  
Disability Weights ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standard Life

AbstractObjective:Reducing the burden of childhood severe acute malnutrition (SAM) is key to improving global child health outcomes. Assessing cost-effectiveness of nutrition interventions remains an important evidence gap. Disability-adjusted life years (DALYs) are a common indicator used in cost-effectiveness analyses. DALYs were established by the Global Burden of Disease (GBD) study. Recent iterations of the GBD have changed the methods used to calculate DALYs by dropping age-weighting and discounting (AD) and updating disability weights (DW). Cost-effectiveness analyses may use either local or international standard life expectancies (LE). Changes in model specifications for calculating DALYs may have implications for cost-effectiveness analyses using DALYs, interpreting historical DALY estimates, and related resource allocation decisions. The present study aimed to quantify the magnitude of change in estimates of DALYs attributable to SAM given recent methodological changes.Design:From secondary data analysis, using parameter values from routine programme monitoring data for two SAM treatment programmes and published literature, eight calculation models were created to estimate DALYs with and without AD, using different sets of DW, and local v. standard LE.Results:Different DW had a marginal effect on DALY estimates. Different LE had a small effect when AD was used, but a large effect when AD was not used.Conclusions:DALY estimates are sensitive to the model used. This complicates comparisons between studies using different models and needs to be accounted for in decision making. It seems sensible for analyses to report results using models with and without AD and using local and standard LE.

scholarly journals Using QALYs versus DALYs to measure cost-effectiveness: How much does it matter?

2020 ◽  
Vol 36 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Xue Feng ◽  
David D. Kim ◽  
Joshua T. Cohen ◽  
Peter J. Neumann ◽  
Daniel A. Ollendorf
Keyword(s):  
Cost Effectiveness ◽  
Medical Center ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Disability Weights ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Relative Differences ◽  
Quality Adjusted Life

ObjectivesQuality-adjusted life-years (QALYs) and disability-adjusted life-years (DALYs) are commonly used in cost-effectiveness analysis (CEA) to measure health benefits. We sought to quantify and explain differences between QALY- and DALY-based cost-effectiveness ratios, and explore whether using one versus the other would materially affect conclusions about an intervention's cost-effectiveness.MethodsWe identified CEAs using both QALYs and DALYs from the Tufts Medical Center CEA Registry and Global Health CEA Registry, with a supplemental search to ensure comprehensive literature coverage. We calculated absolute and relative differences between the QALY- and DALY-based ratios, and compared ratios to common benchmarks (e.g., 1× gross domestic product per capita). We converted reported costs into US dollars.ResultsAmong eleven published CEAs reporting both QALYs and DALYs, seven focused on pharmaceuticals and infectious disease, and five were conducted in high-income countries. Four studies concluded that the intervention was “dominant” (cost-saving). Among the QALY- and DALY-based ratios reported from the remaining seven studies, absolute differences ranged from approximately $2 to $15,000 per unit of benefit, and relative differences from 6–120 percent, but most differences were modest in comparison with the ratio value itself. The values assigned to utility and disability weights explained most observed differences. In comparison with cost-effectiveness thresholds, conclusions were consistent regardless of the ratio type in ten of eleven cases.ConclusionsOur results suggest that although QALY- and DALY-based ratios for the same intervention can differ, differences tend to be modest and do not materially affect comparisons to common cost-effectiveness thresholds.

scholarly journals Estimation of Burden of Cystic Echinococcosis in Iran Using Disability Adjusted Life Years (DALYs) in 2018

2021 ◽  
Author(s):  
Fateme Parandin ◽  
Fatemeh Heydarpour ◽  
Mehdi Mohebali ◽  
Ahmad Ali Hanafi-Bojd ◽  
Ali Akbari Sari ◽  
...  
Keyword(s):  
Premature Death ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Public Concern ◽  
Policy Makers ◽  
Control Programs ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standard Life ◽  
And Control

Background: Human hydatidosis as a public concern has increased in a number of countries that have reduced control programs for the disease due to lack of resources or policies. We aimed to estimate Disability-Adjusted Life Years (DALYs) for human hydatidosis in Iran in 2018. Methods: Data were collected from the Center of Communicable Diseases Control, Ministry of Health &Medical Education, Tehran, Iran in 2018. To calculate DALYs, years of life lost due to premature death (YLL) with years of life with disability (YLD) were calculated according to the formula as DALY = YLL + YLD. The standard life expectancy lost method (SEYLL) was used to calculate the years lost due to premature death. Results: DALYs for human hydatidosis was calculated as 1210.12 years (YLD equals to 177.12 and YLL equals to 1033) in Iran for the year 2018. It was estimated to be 700.2 years for men and 509.8 years for women.  DALYs in men were significantly different from women (P= 0.001) so DALYs were more in men than women were. YLD was calculated at 78.228 years in men and 98.892 years in women and in both men and women at 177.12 years. YLD was significantly different in women compared to men (P=0.001), so YLD in women was more than in men. Conclusion: We reached considerable indices for hydatidosis in our study. Therefore, disease prevention and control programs in Iran seem necessary by the policy makers.

scholarly journals Cost Effectiveness Analysis Using Disability-Adjusted Life Years for Cataract Surgery

2020 ◽  
Vol 17 (16) ◽  
pp. 6010
Author(s):  
Thinni Nurul Rochmah ◽  
Anggun Wulandari ◽  
Maznah Dahlui ◽  
Ernawaty ◽  
Ratna Dwi Wulandari
Keyword(s):  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Cost Effective ◽  
Disability Adjusted Life Years ◽  
Cost Effectiveness Ratio ◽  
Small Incision Cataract Surgery ◽  
Post Surgery ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Cost

Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY.

scholarly journals Control of snakebite envenoming: A mathematical modeling study

2021 ◽  
Vol 15 (8) ◽  
pp. e0009711
Author(s):  
Shuaibu Ahijo Abdullahi ◽  
Abdulrazaq Garba Habib ◽  
Nafiu Hussaini
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Control Strategies ◽  
Real Data ◽  
Disability Adjusted Life Years ◽  
Health Awareness ◽  
Data Set ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact

A mathematical model is designed to assess the impact of some interventional strategies for curtailing the burden of snakebite envenoming in a community. The model is fitted with real data set. Numerical simulations have shown that public health awareness of the susceptible individuals on snakebite preventive measures could reduce the number of envenoming and prevent deaths and disabilities in the population. The simulations further revealed that if at least fifty percent of snakebite envenoming patients receive early treatment with antivenom a substantial number of deaths will be averted. Furthermore, it is shown using optimal control that combining public health awareness and antivenom treatment averts the highest number of snakebite induced deaths and disability adjusted life years in the study area. To choose the best strategy amidst limited resources in the study area, cost effectiveness analysis in terms of incremental cost effectiveness ratio is performed. It has been established that the control efforts of combining public health awareness of the susceptible individuals and antivenom treatment for victims of snakebite envenoming is the most cost effective strategy. Approximately the sum of US$72,548 is needed to avert 117 deaths or 2,739 disability adjusted life years that are recorded within 21 months in the study area. Thus, the combination of these two control strategies is recommended.

CRUCIAL FACTORS THAT INFLUENCE COST-EFFECTIVENESS OF UNIVERSAL HEPATITIS B IMMUNIZATION IN INDIA

2003 ◽  
Vol 19 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Charu Prakash
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis B ◽  
Latin Hypercube Sampling ◽  
Hypothetical Cohort ◽  
Disability Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Cost

This study examines the parameters crucial to cost-effectiveness of universal hepatitis B immunization in India. An incremental cost-effectiveness analysis was done using a decision tree (Markov model) to follow up a hypothetical cohort of 100,000 newborns for the effects of hepatitis B acquired vertically at birth. The measure of effectiveness was disability-adjusted life-years gained. Uncertainty analysis and Scenario analysis were done using Latin hypercube sampling. Hepatitis B endemicity is the most important factor, followed by the cost of vaccine. Other factors of some influence are vaccination coverage, vaccine efficacy, HBeAg positivity, and vaccine wastage.

scholarly journals Cost-effectiveness of community-based screening and treatment of moderate acute malnutrition in Mali

2019 ◽  
Vol 4 (2) ◽  
pp. e001227 ◽  
Author(s):  
Sheila Isanaka ◽  
Dale A Barnhart ◽  
Christine M McDonald ◽  
Robert S Ackatia-Armah ◽  
Roland Kupka ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Dietary Supplements ◽  
Severe Acute Malnutrition ◽  
Morbidity And Mortality ◽  
Acute Malnutrition ◽  
Tree Model ◽  
Risk Of Death ◽  
Life Years ◽  
Wide Range ◽  
Moderate Acute Malnutrition

IntroductionModerate acute malnutrition (MAM) causes substantial child morbidity and mortality, accounting for 4.4% of deaths and 6.0% of disability-adjusted life years (DALY) lost among children under 5 each year. There is growing consensus on the need to provide appropriate treatment of MAM, both to reduce associated morbidity and mortality and to halt its progression to severe acute malnutrition. We estimated health outcomes, costs and cost-effectiveness of four dietary supplements for MAM treatment in children 6–35 months of age in Mali.MethodsWe conducted a cluster-randomised MAM treatment trial to describe nutritional outcomes of four dietary supplements for the management of MAM: ready-to-use supplementary foods (RUSF; PlumpySup); a specially formulated corn–soy blend (CSB) containing dehulled soybean flour, maize flour, dried skimmed milk, soy oil and a micronutrient pre-mix (CSB++; Super Cereal Plus); Misola, a locally produced, micronutrient-fortified, cereal–legume blend (MI); and locally milled flour (LMF), a mixture of millet, beans, oil and sugar, with a separate micronutrient powder. We used a decision tree model to estimate long-term outcomes and calculated incremental cost-effectiveness ratios (ICERs) comparing the health and economic outcomes of each strategy.ResultsCompared to no MAM treatment, MAM treatment with RUSF, CSB++, MI and LMF reduced the risk of death by 15.4%, 12.7%, 11.9% and 10.3%, respectively. The ICER was US$9821 per death averted (2015 USD) and US$347 per DALY averted for RUSF compared with no MAM treatment.ConclusionMAM treatment with RUSF is cost-effective across a wide range of willingness-to-pay thresholds.Trial registrationNCT01015950.

scholarly journals Cost-effectiveness of current and optimal treatment for schizophrenia

2003 ◽  
Vol 183 (5) ◽  
pp. 427-435 ◽  
Author(s):  
Gavin Andrews ◽  
Kristy Sanderson ◽  
Justine Corry ◽  
Cathy Issakidis ◽  
Helen Lapsley
Keyword(s):  
Cost Effectiveness ◽  
Epidemiological Data ◽  
Optimal Treatment ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Life Years Lost ◽  
Years Lived With Disability ◽  
The Cost ◽  
Similar Cost

BackgroundThis paper is part of a project to identify the proportion of the burden of each mental disorder averted by current and optimal interventions, and the cost-effectiveness of both.AimsTo use epidemiological data on schizophrenia to model the cost-effectiveness of current and optimal treatment.MethodCalculate the burden of schizophrenia in the years lived with disability (YLD) component of disability-adjusted life-years lost, the proportion averted by current interventions, the proportion that could be averted by optimal treatment and the cost-effectiveness of both.ResultsCurrent interventions avert some 13% of the burden, whereas 22% could be averted by optimal treatment. Current interventions cost about AUS$200 000 per YLD averted, whereas optimal treatment at a similar cost could increase the number of YLDs averted by two-thirds. Even so, the majority of the burden of schizophrenia remains unavertable.ConclusionsOptimal treatment is affordable within the present budget and should be implemented.

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