scholarly journals Health economic analyses of the Global Programme to Eliminate Lymphatic Filariasis

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S71-S74
Author(s):  
Hugo C Turner
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Cost Effectiveness ◽  
Lymphatic Filariasis ◽  
Management Strategies ◽  
Public Health Problem ◽  
Cost Effective ◽  
Economic Benefits ◽  
Economic Research ◽  
The Cost

Abstract The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established by the WHO in 2000. It aims to eliminate lymphatic filariasis as a public health problem. This paper summarises the key estimates of the cost-effectiveness and economic benefits related to the mass drug administration (MDA) provided by the GPELF. Several studies have investigated the cost-effectiveness of this MDA, estimating the cost per disability-adjusted life year (DALY) averted. These cost-effectiveness estimates have consistently classed the intervention as cost-effective and as favourable compared with other public health interventions conducted in low- and middle-income countries. Studies have also found that the MDA used for lymphatic filariasis control generates significant economic benefits. Although these studies are positive, there are still important gaps that warrant further health economic research (particularly, the evaluation of alternative interventions, further evaluation of morbidity management strategies and evaluation of interventions for settings coendemic with Loa loa). To conclude, health economic studies for a programme as large as the GPELF are subject to uncertainty. That said, the GPELF has consistently been estimated to be cost-effective and to generate notable economic benefits by a number of independent studies.

scholarly journals Cost-Effectiveness Analysis of a Large-Scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

2021 ◽  
Author(s):  
Y. Natalia Alfonso ◽  
Adnan A Hyder ◽  
Olakunle Alonge ◽  
Shumona Sharmin Salam ◽  
Kamran Baset ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Societal Perspective ◽  
Large Scale ◽  
Operating Cost ◽  
Cost Effective ◽  
Economic Benefits ◽  
Program Cost ◽  
Rural Bangladesh ◽  
Life Years ◽  
The Cost

Abstract Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche intervention in preventing child drowning. Estimates of the effectiveness of the crèches was based on prior studies and the program cost was assessed using monthly program expenditures captured prospectively throughout the study period from two different implementing agencies. The study evaluated the cost-effectiveness from both a program and societal perspective. Results showed that from the program perspective the annual operating cost of a crèche was $416.35 (95%C.I.: $222 to $576), the annual cost per child was $16 (95%C.I.: $9 to $22) and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,803 (95%C.I.: $9,051 to $27,625). From the societal perspective (including parents time valued) the ICER per life saved was -$176,62 (95%C.I.: -$347,091 to -$67,684)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $2,020, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Based on the evidence, the creche intervention has great potential for reducing child drowning at a cost that is reasonable.

scholarly journals Can polygenic risk scores contribute to cost-effective cancer screening? A systematic review

2021 ◽  
Author(s):  
Padraig Dixon ◽  
Edna Keeney ◽  
Jenny C Taylor ◽  
Sarah Wordsworth ◽  
Richard Martin
Keyword(s):  
Systematic Review ◽  
Health Economic ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cost Effective ◽  
Risk Scores ◽  
Polygenic Risk ◽  
The Cost ◽  
Economic Studies

Polygenic risk is known to influence susceptibility to cancer. The use of data on polygenic risk, in conjunction with other predictors of future disease status, may offer significant potential for preventative care through risk-stratified screening programmes. An important element in the evaluation of screening programmes is their cost-effectiveness. We undertook a systematic review of papers evaluating the cost-effectiveness of screening interventions informed by polygenic risk scores compared to more conventional screening modalities. We included papers reporting cost-effectiveness outcomes in the English language published as articles or uploaded onto preprint servers with no restriction on date, type of cancer or form of polygenic risk modelled. We excluded papers evaluating screening interventions that did not report cost-effectiveness outcomes or which had a focus on monogenic risk. We evaluated studies using the Quality of Health Economic Studies checklist. Ten studies were included in the review, which investigated three cancers: prostate (n=5), colorectal (n=3) and breast (n=2). All study designs were cost-utility papers implemented as Markov models (n=6) or microsimulations (n=4). Nine of ten papers scored highly (score >75 on a 0-100) scale) when assessed using the Quality of Health Economic Studies checklist. Eight of ten studies concluded that polygenic risk informed cancer screening was likely to be more cost-effective than alternatives. However, the included studies lacked robust external data on the cost of polygenic risk stratification, did not account for how very large volumes of polygenic risk data on individuals would be collected and used, did not consider ancestry-related differences in polygenic risk, and did not fully account for downstream economic sequalae stemming from the use of polygenic risk data in these ways. These topics merit attention in future research on how polygenic risk data might contribute to cost-effective cancer screening.

The health economic benefits of perioperative patient warming for prevention of blood loss and transfusion requirements as a consequence of inadvertent perioperative hypothermia

2018 ◽  
Vol 28 (9) ◽  
pp. 215-222 ◽  
Author(s):  
Andy Ingram ◽  
Mark Harper
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Blood Loss ◽  
Economic Benefits ◽  
Perioperative Hypothermia ◽  
Patient Pathways ◽  
Transfusion Requirements ◽  
The Cost

Active warming of patients is recommended by The National Institute for Health and Care Excellence (NICE) to prevent inadvertent perioperative hypothermia (IPH). This paper examines the cost effectiveness of one consequence of IPH, an increase in blood loss and the resulting transfusion risk. We quantified the risk and modelled two patient pathways, one with and one without warming, across two different surgery types. We were able to demonstrate the cost effectiveness of active warming based on one consequence even allowing for uncertainties in the model.

scholarly journals The economic impact and cost-effectiveness of combined vector-control and dengue vaccination strategies in Thailand: results from a dynamic transmission model

2020 ◽  
Vol 14 (10) ◽  
pp. e0008805
Author(s):  
Gerhart Knerer ◽  
Christine S. M. Currie ◽  
Sally C. Brailsford
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Vector Control ◽  
Dengue Fever ◽  
Control Strategies ◽  
Cost Effective ◽  
Scenario Analyses ◽  
Life Years ◽  
The Cost ◽  
The Impact

Background and aims Dengue fever is a major public health problem in tropical/subtropical regions. Prior economic analyses have predominantly evaluated either vaccination or vector-control programmes in isolation and do not really consider the incremental benefits and cost-effectiveness of mixed strategies and combination control. We estimated the cost-effectiveness of single and combined approaches in Thailand. Methods The impacts of different control interventions were analysed using a previously published mathematical model of dengue epidemiology and control incorporating seasonality, age structure, consecutive infection, cross protection, immune enhancement and combined vector-host transmission. An economic model was applied to simulation results to estimate the cost-effectiveness of 4 interventions and their various combinations (6 strategies): i) routine vaccination of 1-year olds; ii) chemical vector control strategies targeting adult and larval stages separately; iii) environmental management/ public health education and awareness [EM/ PHEA]). Payer and societal perspectives were considered. The health burden of dengue fever was assessed using disability-adjusted life-years (DALYs) lost. Costs and effects were assessed for 10 years. Costs were discounted at 3% annually and updated to 2013 United States Dollars. Incremental cost-effectiveness analysis was carried out after strategies were rank-ordered by cost, with results presented in a table of incremental analysis. Sensitivity and scenario analyses were undertaken; and the impact and cost-effectiveness of Wolbachia was evaluated in exploratory scenario analyses. Results From the payer and societal perspectives, 2 combination strategies were considered optimal, as all other control strategies were dominated. Vaccination plus adulticide plus EM/ PHEA was deemed cost-effective according to multiple cost-effectiveness criteria. From the societal perspective, incremental differences vs. adulticide and EM/ PHEA resulted in costs of $157.6 million and DALYs lost of 12,599, giving an expected ICER of $12,508 per DALY averted. Exploratory scenario analyses showed Wolbachia to be highly cost-effective ($343 per DALY averted) vs. other single control measures. Conclusions Our model shows that individual interventions can be cost-effective, but that important epidemiological reductions and economic impacts are demonstrated when interventions are combined as part of an integrated approach to combating dengue fever. Exploratory scenario analyses demonstrated the potential epidemiological and cost-effective impact of Wolbachia when deployed at scale on a nationwide basis. Our findings were robust in the face of sensitivity analyses.

scholarly journals Cost- Effectiveness Analysis of Infectious Waste Treatment Devices in Hospital

2018 ◽  
pp. 645-649
Author(s):  
Maryam Khashij ◽  
Mohsen Pakdaman ◽  
Mohammad Mehralian ◽  
Mehran Abtahi ◽  
Mehdi Mokhtari
Keyword(s):  
Cost Effectiveness ◽  
Discount Rate ◽  
Waste Treatment ◽  
Public Health Problem ◽  
Cost Effective ◽  
Total Cost ◽  
Sensitivity Rate ◽  
Useful Life ◽  
Infectious Waste ◽  
The Cost

Introduction: Today, the infectious wastes of hospitals are considered as a public health problem. Considering the huge amounts of hazardous wastes and the disadvantages of incinerators, we need to investigate the non-combustible devices involved in biochemical treatment. This study was carried out with the aim of evaluating the cost-effectiveness of infectious wastes devices. Materials and Methods: This descriptive-analytical study was conducted to evaluate the cost-effectiveness and economic efficiency of the infectious waste devices in Yazd and Isfahan hospitals.  In this study, the total cost of infectious waste treatment systems in hospitals, the Incremental Cost Effectiveness Ratio (ICER), as well as the sensitivity rate for the reduction of infectious wastes were calculated using Treeage software version 2011. In order to calculate the cost effectiveness using the total cost and the amount of produced waste, we applied the discount rate of five percent and the useful life of 10 years for each device. Results: Based on the results, devices A and F had the highest and the lowest total cost, respectively. In addition, autoclave D with an ICER of 257.20 was more cost effective than other devices. So, device D, with a discount rate of ±5 and a range of 244.244 - 270.06 was chosen as the best option for infectious waste disposal. Conclusion: The results can be used to explore and outline the future prospects for choosing the best technology for treatment of infectious waste in hospitals. In other words, we have different options on different circumstances and occasions

scholarly journals Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047072
Author(s):  
Kathy W Tannous ◽  
Ajesh George ◽  
Moin Uddin Ahmed ◽  
Anthony Blinkhorn ◽  
Hannah G Dahlen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Oral Health ◽  
Health Benefit ◽  
Cost Effective ◽  
Economic Benefits ◽  
Dental Service ◽  
Public Healthcare ◽  
Life Years ◽  
The Cost

ObjectivesTo critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed positive outcomes and improvements across various measures.Design and settingThe evaluation used a cost-utility model based on the initial study design of the MIOH-DS trial in Sydney, Australia from the perspective of public healthcare provider for a duration of 3 months to 4 years.ParticipantsData were sourced from pregnant women (n=638), midwives (n=17) and dentists (n=3) involved in the MIOH trial and long-term follow-up.Cost measuresData included in analysis were the cost of the time required by midwives and dentists to deliver the intervention and the cost of dental treatment provided. Costs were measured using data on utilisation and unit price of intervention components and obtained from a micro-costing approach.Outcome measuresUtility was measured as the number of Disability Adjusted Life Years (DALYs) from health-benefit components of the intervention. Three cost-effectiveness analyses were undertaken using different comparators, thresholds and time scenarios.ResultsCompared with current practice, midwives only intervention meets the Australian threshold (A$50 000) of being cost-effective. The midwives and accessible/affordable dentists joint intervention was only ‘cost-effective’ in 6 months or beyond scenarios. When the midwife only intervention is the comparator, the midwife/dentist programme was ‘cost-effective’ in all scenarios except at 3 months scenario.ConclusionsThe midwives’ only intervention providing oral health education, assessment and referral to existing dental services was cost-effective, and represents a low cost intervention. Midwives’ and dentists’ combined interventions were cost-effective when the benefits were considered over longer periods. The findings highlight short and long term economic benefits of the programme and support the need for policymakers to consider adding an oral health component into antenatal care Australia wide.Trial registration numberACTRN12612001271897; Post-results.

scholarly journals Investment success in public health: An analysis of the cost-effectiveness and cost-benefit of the Global Programme to Eliminate Lymphatic Filariasis

2016 ◽  
pp. ciw835 ◽  
Author(s):  
Hugo C Turner ◽  
Alison A Bettis ◽  
Brian K Chu ◽  
Deborah A McFarland ◽  
Pamela J Hooper ◽  
...  
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Lymphatic Filariasis ◽  
Cost Benefit ◽  
The Cost

scholarly journals Cost-Effectiveness of Public Health Measures to Control COVID-19 in China: A Microsimulation Modeling Study

2022 ◽  
Vol 9 ◽  
Author(s):  
Qiang Wang ◽  
Naiyang Shi ◽  
Jinxin Huang ◽  
Liuqing Yang ◽  
Tingting Cui ◽  
...  
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Delay Time ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Personal Protection ◽  
Health Measures ◽  
Imported Cases ◽  
Joint Strategy ◽  
The Cost

This study aimed to assess the cost-effectiveness of various public health measures in dealing with coronavirus disease 2019 (COVID-19) in China. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (imported one case) and scenario II (imported four cases) with a series of public health measures. The main outcomes included the avoided infections and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to assess uncertainty. The results indicated that isolation-and-quarantine averted the COVID-19 outbreak at the lowest ICERs. The joint strategy of personal protection and isolation-and-quarantine averted one more case than only isolation-and-quarantine with additional costs. The effectiveness of isolation-and-quarantine decreased with lowering quarantine probability and increasing delay time. The strategy that included community containment would be cost-effective when the number of imported cases was >65, or the delay time of the quarantine was more than 5 days, or the quarantine probability was below 25%, based on current assumptions. In conclusion, isolation-and-quarantine was the most cost-effective intervention. However, personal protection combined with isolation-and-quarantine was the optimal strategy for averting more cases. The community containment could be more cost-effective as the efficiency of isolation-and-quarantine drops and the imported cases increases.

scholarly journals Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Y. Natalia Alfonso ◽  
Adnan A. Hyder ◽  
Olakunle Alonge ◽  
Shumona Sharmin Salam ◽  
Kamran Baset ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Societal Perspective ◽  
Large Scale ◽  
Operating Cost ◽  
Cost Effective ◽  
Economic Benefits ◽  
Program Cost ◽  
Rural Bangladesh ◽  
Life Years ◽  
The Cost

Abstract Background Drowning is the leading cause of death among children 12–59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning. Methods The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective. Results From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was − $166,833 (95% CI: − $197,421 to − $141,341)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Conclusions Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable.

Which treatments are cost-effective in the management of varicose veins?

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 153-157 ◽  
Author(s):  
M Gohel
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Varicose Veins ◽  
Cost Effective ◽  
Outpatient Setting ◽  
Cost Effective Treatment ◽  
Great Scrutiny ◽  
Quality Health ◽  
Economic Analyses ◽  
The Cost

In the current economic climate, the cost-effectiveness of health-care interventions is under great scrutiny. In this article, the evidence for cost-effectiveness of treatments for varicose veins is summarized. The majority of studies evaluating treatments for varicose veins have not assessed health economic outcomes, but have focused on clinical and anatomical measures. The cost-effectiveness of treating varicose veins (compared with conservative management) was demonstrated in the REACTIV trial. Other in-trial economic analyses suggested that endovenous interventions are likely to be cost-effective and a decision tree analysis demonstrated that the greatest cost-effectiveness may be present for procedures performed under local or tumescent anaesthesia in the office or outpatient setting. However, the treatment modality that offers the greatest cost-effectiveness remains unclear. In conclusion, endovenous treatment performed in the outpatient setting under local anaesthesia is likely to be the most cost-effective treatment strategy for varicose veins. Better quality health economic analyses are needed to refine this conclusion.

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