TABLE 1.

Types of Interventions Studied in US Public Health Cost-Utility Analyses, 1976–2003

Disease	Intervention	$/QALYab	Author
Screening
Cancer	One-time colonoscopic screening for colorectal cancer	Cost-savingc	Ness et al.20
	Continued Pap and HPV testing to screen for cervical cancer into very old age	80 000	Mandelblatt et al.21
Diabetes	Diabetic retinopathy screening in patients with type 2 diabetes mellitus	19 000	Vijan et al.22
	Screening for type 2 diabetes in individuals ≥ 25 years old	67 000	CDC Diabetes Cost-Effectiveness Study Group23
Infection	Genetic screening for prevention of rheumatic fever	8 500	King et al.24
Kidney	Screening for proteinuria	19 000	Boulware et al.25
Pre- and postnatal	Universal newborn screening by tandem mass spectrometry for medium-chain Acyl-CoA dehydrogenase deficiency	5 700	Venditti et al.26
	Universal newborn tandem mass spectrometry	6 100	Schoen et al.27
	Screening for cystic fibrosis carriers	9 500	Rowley et al.28
	Newborn tandem mass spectrometry for acidemia disorders	15 000	Insinga et al.29
Immunization
Blood-borne illnesses, STDs	Hepatitis A/B immunization	Cost-saving	Jacobs et al.30
	Hepatitis A/B vaccination vs. hepatitis B vaccination	13 000	Jacobs and Meyerhoff31
	Universal vaccination for HPV	23 000	Sanders and Taira32
	Hepatitis A vaccination	55 000	Arguedas et al.33
Respiratory and other infections	Haemophilus influenzae type b vaccination	Cost-saving	Zhou et al.34
	Hypothetical respiratory syncytial virus vaccination	6 100	Gessner35
	Increasing measles immunization rates	52 000	Zwanziger et al.36
	Pneumococcal vaccination	56 000	Pepper and Owens37
	Vaccination against invasive pneumococcal disease	4 100	Sisk et al.38
Regulatory and education policy
Multiple	Vitamin supplementation to lower plasma homocysteine levels	1 000	Tice et al.39
	Switching smoking cessation drugs to over-the-counter status	16 000	Keeler et al.40
	Intensive national school-based antitobacco education	20 000	Tengs et al.41
	Restrictions on the use of cell phones while driving	75 000	Cohen and Graham42
	Switching to use of emission-controlled urban transit buses	270 000	Cohen et al.43
	Regulations against using a cellular telephone while driving	350 000	Redelmeier and Weinstein44
Care delivery
	Resuscitation with publicly accessible automated external defibrillators	30 000	Cram et al.45
	Public access defibrillation by police	32 000	Nichol et al.46
	Training program for automated external defibrillators on aircrafts	36 000	Groeneveld et al.47
	Rapid defibrillation by targeted nontraditional responders	55 000	Nichol et al.48
HIV	State AIDS drug assistance programs in Oklahoma vs. Mississippi	18 000	Johri et al.49
	HIV postexposure prophylaxis according to US Public Health Service guidelines	91 000	Scheid et al.50
HIV and STD health behavior
	Condom distribution	Cost-saving	Bedimo et al.51
	HIV risk reduction counseling and education	7 500	Tao and Remafedi52
	Intervention on sexual behavior and condom use	37 000	Chesson et al.53
	HIV cognitive-behavioral risk reduction intervention	64 000	Pinkerton et al.54
Injury prevention
Injury	Safety-belt law	Cost-saving	Zaloshnja et al.55
	Safety-belt law	40d	Zaloshnja et al.56
	Air bags in cars	24 000	Graham et al.57
	Hip protectors for women	Cost-saving	Segui-Gomez58
	Drowning prevention program	Cost-saving	Zaloshnja et al.55
	Streetlight installation	Cost-saving	Zaloshnja et al.55,56
	Livestock control project	Cost-saving or fewer QALYs	Zaloshnja et al.55,56
	Suicide prevention program	460	Zaloshnja et al.55
Blood testing
Multiple	HIV antibody testing of donated blood	Cost-saving	AuBuchon et al.59
	Alanine aminotransferase testing of donated blood	3 600	Busch et al.60
	Solvent-detergent treatment of fresh-frozen plasma for transfusion	289 000	AuBuchon and Birkmeyer61
Surveillance
	Tuberculosis skin testing and treatment	Cost-saving	Khan et al.62
	Surveillance of cancer risk in Barrett's esophagus	120 000	Provenzale et al.63
Other health
	Donor heart transplantation	31 000	Mendeloff64
	Donor liver transplantation	35 000	Mendeloff64

Note. QALY = quality-adjusted life-year; HPV = human papillomavirus; STD = sexually transmitted disease.

Source. Center for the Evaluation of Value and Risk in Health.⁶

^aAll values presented in 2003 US dollars. “$/QALY” measures the cost-effectiveness of an intervention by comparing it with an alternative intervention via a ratio of incremental costs over incremental quality-adjusted life years gained because of an intervention.

^bThe cost-effectiveness ratios listed are point-estimate values from original articles dating 1976–2003 included in the Tufts Medical Center Cost-Effectiveness Analysis Registry. The cost-effectiveness ratios will vary according to the precise strategies, target populations, and perspective used. Additional data on the cost-effectiveness ratios associated with public health can be found at: http://www.cearegistry.org.

^cCost-saving means the intervention saves money and increases QALYs.

^dDecreases costs and decreases QALYs.