Table 2.
Cost per DALY averted estimates relating to the predominantly used preventive chemotherapy strategies
| Study, publication year | Intervention and setting | Approach used to estimate the effectiveness and time horizon | Assumed average costs of preventive chemotherapy | Average cost-effectiveness ratio per DALY averted | Cost year |
| Lymphatic filariasis: | |||||
| Remme et al (DCP2), 2006102 | Annual mass community-wide treatment—hypothetical setting (intervention time frame: up to 30 years—depending on when elimination is projected to be achieved) | Back of the envelope (time horizon: 30 years) | Unclear | US$29 within the control scenario and between US$4.40–8.10 within two elimination scenarios | Unclear |
| Turner et al, 201757 | Annual mass community-wide treatment—given within GPELF between 2000–2014 (intervention time frame: 15 years) | Static model (time horizon: lifetime of those treated) | Financial cost: US$0.46 per treatment Economic cost (excluding the donated drugs value): US$0.56 per treatment Economic cost (including the donated drugs value): US$1.32 per treatment |
Financial cost: US$24 Economic cost (excluding the donated drugs value): US$29 Economic cost (including the donated drugs value): US$64 |
2014 |
| Onchocerciasis: | |||||
| Remme et al (DCP2), 2006102 | Annual mass community-wide treatment—given within APOC between 1995–2010 (intervention time frame: 15 years) | Back of the envelope (time horizon: 25 years) | APOC (1995–2010) costing in total US$209 million (financial cost) | US$7 | Unclear |
| Coffeng et al, 2013103 | Annual mass community-wide treatment—given within APOC between 1995–2015 (intervention time frame: 20 years) | Dynamic transmission model (time horizon: 20 years (1995–2015)) | Financial delivery cost: US$0.51 per treatment | US$27 | Nominal values |
| Turner et al, 2014104 | Annual mass community-wide treatment—given within a savannah setting in Africa at different levels of endemicity (intervention time frame: up to 50 years—depending on when elimination is projected to be achieved) | Dynamic transmission model (time horizon: 50 years) | Economic delivery cost: US$0.52 per treatment. Drug cost: US$4.21 per treatment |
Economic cost (excluding the donated drugs value): US$3–15 Economic cost (including the donated drugs value): US$29–133 |
2012 |
| Schistosomiasis: | |||||
| Hotez et al (DCP2), 20067 | Annual mass school-based treatment—hypothetical setting (intervention time frame: unclear) | Back of the envelope (time horizon: unclear) | Not stated | US$336–692 (note that this at times incorrectly quoted as US$3.36–6.92 within the report105 | Unclear |
| GiveWell, 2011106 | Annual mass school-based treatment—hypothetical setting (intervention time frame: one treatment round) | Back of the envelope (time horizon: one treatment round) | US$0.27–0.47 per treatment (including drug costs) | US$28.19–70.48 | Unclear |
| Lo et al, 201632 | Annual mass school-based treatment—hypothetical setting (time frame for the intervention: 5 years) | Dynamic transmission model (time horizon: 5 years) | US$0.71 per treatment (including drug costs) |
15% prevalence in SAC: US$449 30% prevalence in SAC: US$160 |
2015 |
| STH: | |||||
| Chan, 1997107 | Mass treating SAC against ascaris—within a high prevalence community (intervention time frame: 10 years) | Dynamic transmission model (time horizon: 10 years) | US$1600 to treat the schoolchildren per 100 000 population in China | US$8 | Unclear |
| Miguel and Kremer, 2004108 | Biannual mass school-based treatment—given within a project in Kenya (intervention time frame: 1 year) | Based on project data (time horizon: 1 year) | Based on US$0.49 per pupil per year (removing the costs related to praziquantel) | US$280 (per STH related DALY averted) | Unclear |
| Hotez et al (DCP2), 20067 | Annual mass school-based treatment—hypothetical setting (intervention time frame: unclear) | Back of the envelope (time horizon: unclear) | Not stated | US$326.43 (note that within the report the results were reported as US$3.41 but there were errors within the calculation105 | Unclear |
| GiveWell, 2011106 | Annual mass school-based treatment—hypothetical setting (intervention time frame: one treatment round) | Back of the envelope (time horizon: one treatment round) | US$0.085 per treatment | US$82.54 | Unclear |
| Lo et al, 201632 | Annual mass school-based treatment—hypothetical setting (intervention time frame: 5 years) | Dynamic transmission model (time horizon: 5 years) | US$0.53 per treatment (including drug costs) |
20% prevalence in SAC: US$1077 60% prevalence in SAC: US$298 85% prevalence in SAC: US$174 |
2015 |
| Schistosomiasis, lymphatic filariasis and STH: | |||||
| De Neve et al, 201859 | Annual mass school-based treatment—based on the preventive chemotherapy programme in Madagascar (intervention time frame: one treatment round) | Static model (time horizon: unclear) | Not directly reported | US$125 (95% uncertainty range: 65–231) | 2013 |
| Schistosomiasis and STH: | |||||
| Warren et al (DCP1), 1993109 | Annual mass school-based treatment with an hypothetical setting (intervention time frame: 10 years) | Static calculation (time horizon: 10 years) |
US$0.8–1.80 per child per year (including drug costs) | US$6–33 | Unclear |
| Miguel and Kremer, 2004108 | Annual mass school-based treatment for schistosomiasis and biannual mass school-based treatment for STH—given within a project in Kenya (intervention time frame: 1 year) | Based on project data (time horizon: 1 year) | US$ 0.49 per pupil per year (including drug costs) | US$5 (99% of the benefit was due to averted schistosomiasis) | Unclear |
| Lo et al, 201531 | Annual mass school-based treatment—within four communities in Côte d'Ivoire (intervention time frame: 15 years) | Dynamic transmission model (time horizon: 15 years) | US$0.71 per treatment (including drug costs) |
US$118 (US$87–140) (92% of the disability resulted from Schistosoma infections) | 2014 |
The selection criteria are outlined in Box 1. It was not possible to adjust the different studies for inflation and they are reported in their original cost year.110
APOC, African Programme for Onchocerciasis Control; DALY, disability-adjusted life year; DCP1, disease control priorities in developing countries (first edition); DCP2, disease control priorities in developing countries (second edition); GPELF, Global Programme to Eliminate Lymphatic Filariasis; SAC, school-aged children; STH, soil-transmitted helminthiases.