Investment Success in Public Health: An Analysis of the Cost-Effectiveness and Cost-Benefit of the Global Programme to Eliminate Lymphatic Filariasis
Investment Success in Public Health: An Analysis of the Cost-Effectiveness and Cost-Benefit of the Global Programme to Eliminate Lymphatic Filariasis
复制标题
公共卫生投资的成功：消除淋巴丝虫病全球方案的成本效益和成本效益分析
DOI：
10.1093/cid/ciw835
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发表时间：
2017-03-15
影响因子：
11.8
通讯作者：
Bradley, Mark H.
中科院分区：
文献类型：
--
作者：
Turner, Hugo C.;Bettis, Alison A.;Bradley, Mark H.
背景据估计，在2015-2020年期间，每年将需要1.54亿美元，以继续执行消除淋巴丝虫病全球方案。有鉴于此，重要的是要了解该计划的当前价值。在这里，我们评估了2000年至2014年期间根据GPELF提供的预防性化疗的成本效益和成本效益。此外，我们还调查了潜在的成本效益鞘膜积液手术。我们对预防性化疗的经济评估是基于先前发表的健康和经济影响估计（2000年至2014年）。使用世界卫生组织开发的模型估算了治疗的交付成本。我们还开发了一个模型来调查由脊髓积水切除术避免的残疾调整生命年（DADs）的数量，并确定了成本阈值，在该阈值下，它将被认为是具有成本效益的。预防性化疗的预期成本效益和成本效益非常有希望，在广泛的成本和假设范围内，这是稳健的。如不计及所募捐药物的经济价值，基金会会被列为具高度成本效益的基金。我们预测，如果手术费用低于66美元，则典型的鞘膜积液切除术将被归类为高成本效益，如果低于398美元，则将被归类为成本效益（基于世界银行对低收入国家的成本效益阈值）。根据GPELF提供的预防性化疗和鞘膜积液手术都具有令人难以置信的成本效益，并为公共卫生提供了非常好的投资。
Background. It has been estimated that $154 million per year will be required during 2015-2020 to continue the Global Programme to Eliminate Lymphatic Filariasis (GPELF). In light of this, it is important to understand the program's current value. Here, we evaluate the cost-effectiveness and cost-benefit of the preventive chemotherapy that was provided under the GPELF between 2000 and 2014. In addition, we also investigate the potential cost-effectiveness of hydrocele surgery.Methods. Our economic evaluation of preventive chemotherapy was based on previously published health and economic impact estimates (between 2000 and 2014). The delivery costs of treatment were estimated using a model developed by the World Health Organization. We also developed a model to investigate the number of disability-adjusted life years (DALYs) averted by a hydrocelectomy and identified the cost threshold under which it would be considered cost-effective.Results. The projected cost-effectiveness and cost-benefit of preventive chemotherapy were very promising, and this was robust over a wide range of costs and assumptions. When the economic value of the donated drugs was not included, the GPELF would be classed as highly cost-effective. We projected that a typical hydrocelectomy would be classed as highly cost-effective if the surgery cost less than $66 and cost-effective if less than $398 (based on the World Bank's cost-effectiveness thresholds for low income countries).Conclusions. Both the preventive chemotherapy and hydrocele surgeries provided under the GPELF are incredibly cost-effective and offer a very good investment in public health.