Table 1.

Characteristics of studies included in the qualitative synthesis

Study	Year	Country	Study design	Diagnosis	Study perspective	Inputs included in cost analysis*	Cost outcomes (in 2018 USD)	CHEERS checklist (out of 24)
Multiple childhood cancers
Bhakta et al 17	2013	Brazil and Malawi	CA, CEA, CUA	ALL and BL	N/A	N/A	Cost-effectiveness thresholds (using 3% discounting): ALL in Brazil: Upper limit of cost effective: $560 106 per case Upper limit of very cost effective: $186 701 per case BL in Malawi: Upper limit of cost effective: $30 273 per case Upper limit of very cost effective: $10 091 per case	21
Fuentes-Alabi et al 18	2018	El Salvador	CA, CEA, CUA	All childhood cancers	Hospital	Comprehensive	Annual cost to maintain paediatric cancer treatment programme: $5 440 465 Cost per newly diagnosed patient per year: $30 035 Cost per DALY averted using 3% discounting: $1699	23
Jasso-Gutierrez et al 41	2012	Mexico	CA	ALL and HL	Not specified	Low	Cost of cancer drugs (remission induction stage and consolidation): ALL: Standard-risk ALL: $4982 for 20 kg child and $6663 for 30 kg child High-risk and very high-risk ALL: $5575 for 20 kg child and $7456 for 30 kg child HL: Stages IA and IIA: $222 for 20 kg child and $277 for 30 kg child. Stages IB and IIB: $2735 for 20 kg child and $3659 for 30 kg child. Stages III and IV: $2883 for 20 kg child and $3857 for 30 kg child	16
Neal et al 49	2018	Rwanda	CA	WT and HL	Hospital	Comprehensive	WT: cost per treated patient per year: $1913 ($1362–$1913) HL: cost per treated patient per year: $1638 ($1042–$1638)	22.5
Renner et al 16	2018	Ghana	CA, CEA, CUA	All childhood cancers	Hospital	Comprehensive	Annual cost to operate a paediatric cancer unit: $1 791 797. Cost per newly diagnosed patient per year: $10 540 Cost per life saved: $30 115 Cost per DALY averted using 3% discounting: $1114	22
Leukaemias
Jaime-Perez et al 40	2017	Mexico	CA	ALL	Public health system, hospital and patient	Medium	Cost per treated patient: $20 954 to $24 788.	20
Gao et al 31	2013	China	CA	ALL	Patient	Low	Cost per treated patient: ALL-BFM 2002: median $14 124 ($8003–$50 002) ALL China-98: median $27 209 ($17 156–$79 334)	16
Garcia et al 32	2015	Colombia	CA, CEA	AML	Heath system	Low	Cost per treated patient: Chemotherapy only: $14 731 Unrelated transplant: $65 486 Related transplant: $85 114 ICER for related transplant compared with chemotherapy: $2744 ICER for unrelated transplant compared with chemotherapy: $3868	23
Ghatak et al 33	2016	India	CA	ALL	Patient	Comprehensive	During first month of therapy (induction phase): Cost of medical expenditure per patient: $574 (IQR $433–$851). Total cost of nonmedical expenditure per patient: $227 (IQR $156–$322).	19
Gu et al 34	2008	China	CA	ALL	Patient	Low	Cost per treated patient was $26 800 for low-risk, $35 734 for medium-risk and $44 667 for high-risk patients, respectively.	13.5
Hayati et al 35	2018	Iran	CUA	ALL	Not specified	Medium	Cost per treated patient: UK-ALL protocol: $9323 BFM-ALL protocol: $16 914 Cost per QALY gained: UK-ALL protocol: $2104 BFM-ALL protocol: $4475	18
Islam et al 38	2015	Bangladesh	CA	ALL	Patient	Comprehensive	Cost per treated patient: $5684 ($4182–$9814)	21
Jayaraman et al 42	2017	India	CA	ALL	Not specified	Low	Cost of each vial of Peg-asparaginase was $2309 Each vial of 3750 units/mL was shared among 3–4 children.	14.5
Liu et al 45	2009	China	CA	ALL	Hospital	Medium	Costs per treated patient: $17 295±10 914 ($8782–78 218)	18.5
Luo et al 46	2008	China	CA	ALL	Patient	Medium	China-98 protocol: Cost per treated patient (median and range): $18 791 ($13 064–$38 487) Modified ALLIC BFM200 protocol: Cost per treated patient (median and range): $14 953 ($10 370–$29 142) Economic protocol: Cost per treated patient (median and range): $6391 ($4683–$10 250)	19
Luo et al 47	2009	China	CA	APL	Not specified	Low	Cost per treated patient: In-house protocol: median $24 704 ($16 305–$34 092) Modified PETHEMA protocol: median $5806 ($3335–$10 623)	11.5
Rocha-Garcia et al 51	2003	Mexico	CA	ALL	Patient	Medium	Cost per treated child: $719	18
Wilms tumour
Israels et al 39	2018	Malawi, Cameroon and Ghana	CA	WT	Patient	Low	Cost per treated patient: $105–$1151.	15.5
Kanyamuhunga et al 44	2015	Rwanda	CA	WT	Hospital and patient	Medium	Cost per treated patient: $1796 for early stage and $2372 for advanced disease stage	19.5
Paintsil et al 50	2015	Ethiopia, Ghana, Cameroon, Malawi and Uganda	CA	WT	Patient	Medium	Cost per treated patient: Komfo Anokye Teaching Hospital (Ghana): $1110 Korle Bu Teaching Hospital (Ghana): $1110 Uganda Cancer Institute (Uganda): $211 Queen Elizabeth Central Hospital (Malawi): $122 Mbingo, Mutengene and Banso Baptist Hospitals (Cameroon): $416 Tikur Anbessa Specialised Hospital (Ethiopia): $388	17
Burkitt lymphoma
Denburg et al 30	2019	Uganda	CA, CEA, CUA	BL	Government	Comprehensive	Cost per treated child US$1401 Annual national cost of treatment: $864 854 Cost per DALY averted using 3% discounting $100	23.5
Hesseling et al 37	2003	Malawi	CA	BL	Not specified	Low	Cost per treated patient: <$217	12.5
Meremikwu et al 48	2005	Nigeria	CA	BL	Patient	Medium	Cost for a 7 years old child with BL (including 6-course treatment regimen): $141	16.5
Traoré et al 53	2011	Burkina-Faso, Cameroon, Ivory Coast, Madagascar, Mali, and Senegal	CA	BL	Not specified	Low	Cost per treated child: $799	12.5
Hodgkin lymphoma
Stefan and Stones52	2009	South Africa	CA	HL	Not specified	Low	HL stage II: cost per treated child $7360	18.5
Retinoblastoma
Ji et al 43	2012	China	CA	Retinoblastoma	Patient	Comprehensive	Cost per treated patient: $9954±$3919 Medical costs: $7250±$3659 Non-medical costs: $2705±$1424	20
Waddell et al 54	2015	Uganda	CA	Retinoblastoma	Not specified	Low	Cost per treated child: $1079.	12.5
Yao et al 55	2018	DRC and Ivory Coast	CA	Retinoblastoma	Not specified	Low	Cost per treated child: Lubumbashi (DRC): $1475 Kinshasa (DRC): $879 Bukavu (DRC): $637 Abidjan (Ivory Coast): $527	10.5
Other
Agarwal et al 29	2007	India	CA	Osteosarcoma	Patient	Low	Cost of rotationplasty: $661 including cost of prosthesis Cost of indigenous non-expandable prosthesis: $1321 Cost of expandable prosthesis: $33 029	13.5
Hendricks et al 36	2011	South Africa	CA	Extracranial germ cell tumours	Not specified	Low	Cost per treated patient by treatment regimen: Cisplatin (×3 cycles) $2470. Carboplatin (×4 cycles $529, (×5 cycles) $662, (×6 cycles) $794	16

*Comprehensive: ≥10 inputs, Medium: 5–9 inputs, Low: <5 inputs.

ALL, acute lymphoblastic leukaemia; AML, acute myeloid leukaemia; APL, acute promyelocytic leukaemia; BL, Burkitt lymphoma; CA, cost analysis; CEA, cost-effectiveness analysis; CUA, cost-utility analysis; DALY, disability-adjusted life year; DRC, Democratic Republic of Congo; HL, Hodgkin lymphoma; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year; WT, Wilms tumour.