scholarly journals Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa

2017 ◽  
Vol 2 (1) ◽  
pp. e000090 ◽  
Author(s):  
Peter Winskill ◽  
Patrick GT Walker ◽  
Jamie T Griffin ◽  
Azra C Ghani
Keyword(s):  
Cost Effectiveness ◽  
Malaria Vaccine ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Cost ◽  
Malaria Interventions

scholarly journals Healthcare Costs and Life-years Gained From Treatments Within the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) Trial on Cryptococcal Meningitis: A Comparison of Antifungal Induction Strategies in Sub-Saharan Africa

2019 ◽  
Vol 69 (4) ◽  
pp. 588-595 ◽  
Author(s):  
Tao Chen ◽  
Lawrence Mwenge ◽  
Shabir Lakhi ◽  
Duncan Chanda ◽  
Peter Mwaba ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Resource Use ◽  
Cryptococcal Meningitis ◽  
Cost Effective ◽  
Sub Saharan Africa ◽  
Cost Effectiveness Ratio ◽  
Parametric Bootstrapping ◽  
Life Years ◽  
Sub Saharan ◽  
The Cost

Abstract Background Mortality from cryptoccocal meningitis remains high. The ACTA trial demonstrated that, compared with 2 weeks of amphotericin B (AmB) plus flucystosine (5FC), 1 week of AmB and 5FC was associated with lower mortality and 2 weeks of oral flucanozole (FLU) plus 5FC was non-inferior. Here, we assess the cost-effectiveness of these different treatment courses. Methods Participants were randomized in a ratio of 2:1:1:1:1 to 2 weeks of oral 5FC and FLU, 1 week of AmB and FLU, 1 week of AmB and 5FC, 2 weeks of AmB and FLU, or 2 weeks of AmB and 5FC in Malawi, Zambia, Cameroon, and Tanzania. Data on individual resource use and health outcomes were collected. Cost-effectiveness was measured as incremental costs per life-year saved, and non-parametric bootstrapping was done. Results Total costs per patient were US $1442 for 2 weeks of oral FLU and 5FC, $1763 for 1 week of AmB and FLU, $1861 for 1 week of AmB and 5FC, $2125 for 2 weeks of AmB and FLU, and $2285 for 2 weeks of AmB and 5FC. Compared to 2 weeks of AmB and 5FC, 1 week of AmB and 5FC was less costly and more effective and 2 weeks of oral FLU and 5FC was less costly and as effective. The incremental cost-effectiveness ratio for 1 week of AmB and 5FC versus oral FLU and 5FC was US $208 (95% confidence interval $91–1210) per life-year saved. Clinical Trials Registration ISRCTN45035509. Conclusions Both 1 week of AmB and 5FC and 2 weeks of Oral FLU and 5FC are cost-effective treatments.

The Cost Effectiveness of a Single-Dose Nevirapine Regimen to Mother and Infant to Reduce Vertical HIV-1 Transmission in Sub-Saharan Africa

2006 ◽  
Vol 918 (1) ◽  
pp. 53-56 ◽  
Author(s):  
ELLIOT MARSEILLE ◽  
JAMES G. KAHN ◽  
FRANCIS MMIRO ◽  
LAURA GUAY ◽  
PHILIPPA MUSOKE ◽  
...  
Keyword(s):  
Single Dose ◽  
Cost Effectiveness ◽  
Sub Saharan Africa ◽  
Single Dose Nevirapine ◽  
Sub Saharan ◽  
The Cost ◽  
Hiv 1

scholarly journals Assessing the Cost-Effectiveness of Contraceptive Methods from a Health Provider Perspective: Case Study of Kiambu County Hospital, Kenya

2020 ◽  
Author(s):  
James Kiragu Ngacha ◽  
Richard Ayah
Keyword(s):  
Cost Effectiveness ◽  
Service Delivery ◽  
Cost Effective ◽  
Sub Saharan Africa ◽  
Contraceptive Methods ◽  
Donor Funding ◽  
Contraceptive Prevalence ◽  
Sub Saharan ◽  
The Cost

Abstract Background: Kenya’s Contraceptive Prevalence Rate at 53% is low, with wide disparity among the 47 counties that make up the country (2% - 76%). Significant financial investment is required to maintain this level of contraceptive use and increase it to levels seen in more developed countries. This is in the context of a growing population, declining donor funding, limited fiscal space and competing health challenges. Studies have shown that long-term contraceptive methods are more cost-effective than short-term methods. However, it is unclear if this applies in Sub-Saharan Africa; with limited financial resources, lower social economic status among users, and publicly managed commodity supply chains, in vertical programs largely dependent on donor funding. This study assessed the cost-effectiveness of contraceptive methods used in Kenya.Methods: A cross-sectional study was undertaken in a county referral hospital in mid-2018. Purposive sampling of 5 Family Planning clinic providers and systematic sampling of 15 service delivery sessions per method was done. Questionnaire aided interviews were done to determine inputs required to provide services and direct observation to measure time taken to provide each method. Cost per method was determined using Activity Based Costing, effectiveness via couple year protection conversion factors, and cost-effectiveness was expressed as cost per couple year protection. Results: The Intra-Uterine Copper Device was most cost-effective at 4.87 US dollars per couple year protection followed by the 2-Rod Implant at 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, while the Combined Oral Contraceptive Pills were least cost-effective at 38.60 US dollars per couple year protection. Long-term methods attracted a higher initial cost of service delivery when compared to short-term methods.Conclusion: Long-term contraceptive methods are more cost-effective. As such, investing in long-term contraceptives would save costs despite higher initial cost of service delivery. It is recommended, therefore, that Sub-Saharan Africa countries allocate more domestic financial resources towards availability of contraceptive services, preferably with multi-year planning and budget commitment. The resources should be invested in a wide range of interventions shown to increase uptake of long-term methods, including reduction of cost barriers for the younger population, thereby increasing Contraceptive Prevalence Rates.

scholarly journals The Cost-Effectiveness of Intermittent Preventive Treatment for Malaria in Infants in Sub-Saharan Africa

PLoS ONE ◽  
2010 ◽  
Vol 5 (6) ◽  
pp. e10313 ◽  
Author(s):  
Lesong Conteh ◽  
Elisa Sicuri ◽  
Fatuma Manzi ◽  
Guy Hutton ◽  
Benson Obonyo ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Cost

scholarly journals How do different eligibility guidelines for antiretroviral therapy affect the cost–effectiveness of routine viral load testing in sub-Saharan Africa?

AIDS ◽  
2014 ◽  
Vol 28 ◽  
pp. S73-S83 ◽  
Author(s):  
Ronald Scott Braithwaite ◽  
Kimberly A. Nucifora ◽  
Christopher Toohey ◽  
Jason Kessler ◽  
Lauren M. Uhler ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Load Testing ◽  
Viral Load Testing ◽  
Sub Saharan ◽  
The Cost

scholarly journals Modelling the cost-effectiveness of introducing subsidised malaria rapid diagnostic tests in the private retail sector in sub-Saharan Africa

2020 ◽  
Vol 5 (5) ◽  
pp. e002138
Author(s):  
David Bath ◽  
Catherine Goodman ◽  
Shunmay Yeung
Keyword(s):  
Cost Effectiveness ◽  
Diagnostic Tests ◽  
Cost Effective ◽  
Rapid Diagnostic Tests ◽  
Sub Saharan Africa ◽  
Small Scale ◽  
Retail Sector ◽  
First Line ◽  
Sub Saharan ◽  
The Cost

BackgroundOver the last 10 years, there has been a huge shift in malaria diagnosis in public health facilities, due to widespread deployment of rapid diagnostic tests (RDTs), which are accurate, quick and easy to use and inexpensive. There are calls for RDTs to be made available at-scale in the private retail sector where many people with suspected malaria seek care. Retail sector RDT use in sub-Saharan Africa (SSA) is limited to small-scale studies, and robust evidence on value-for-money is not yet available. We modelled the cost-effectiveness of introducing subsidised RDTs and supporting interventions in the SSA retail sector, in a context of a subsidy programme for first-line antimalarials.MethodsWe developed a decision tree following febrile patients through presentation, diagnosis, treatment, disease progression and further care, to final health outcomes. We modelled results for three ‘treatment scenarios’, based on parameters from three small-scale studies in Nigeria (TS-N), Tanzania (TS-T) and Uganda (TS-U), under low and medium/high transmission (5% and 50% Plasmodium falciparum (parasite) positivity rates (PfPR), respectively).ResultsCost-effectiveness varied considerably between treatment scenarios. Cost per disability-adjusted life year averted at 5% PfPR was US$482 (TS-N) and US$115 (TS-T) and at 50% PfPR US$44 (TS-N) and US$45 (TS-T), from a health service perspective. TS-U was dominated in both transmission settings.ConclusionThe cost-effectiveness of subsidised RDTs is strongly influenced by treatment practices, for which further evidence is required from larger-scale operational settings. However, subsidised RDTs could promote increased use of first-line antimalarials in patients with malaria. RDTs may, therefore, be more cost-effective in higher transmission settings, where a greater proportion of patients have malaria and benefit from increased antimalarial use. This is contrary to previous public sector models, where RDTs were most cost-effective in lower transmission settings as they reduced unnecessary antimalarial use in patients without malaria.

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