Table 2:
Summary benefit and cost results from selected scenarios, 2021–30
| Primary prophylaxis only†* |
Integrated secondary and tertiary care only† |
All interventions‡ | |
|---|---|---|---|
| RHD incident cases averted (thousands) | 187·2 (113·3 to 247·2) | 184·5 (31·0 to 310·6) | 361·5 (207·2 to 497·3) |
| RHD deaths averted (thousands) | 0·8 (0·5 to 1·1) | 59·5 (40·3 to 76·3) | 60·0 (40·8 to 76·8) |
| ARF deaths averted (thousands) | 7·2 (1·5 to 19·6) | 7·1 (0·5 to 22·1) | 13·9 (2·4 to 38·3) |
| Cost (billions, US$) | 3·1 (1·9 to 4·3) | 1·0 (0·7 to 1·2) | 3·9 (2·7 to 5·1) |
| Cost per death averted (thousands, US$) | 526·1 (155·2 to 1389·4) | 14·8 (10·6 to 22·7) | 54·4 (33·8 to 83·5) |
| Full income benefit (billions, US$) | 0·5 (0·1 to 1·2) | 4·5 (3·0 to 5·9) | 4·9 (3·3 to 6·7) |
| Benefit–cost ratio to 2030 | 0·2 (<0·1 to 0·4) | 4·7 (2·9 to 6·3) | 1·3 (0·8 to 1·9) |
| Benefit–cost ratio to 2090§ | 0·7 (0·4 to 1·1) | 8·4 (4·8 to 12·1) | 3·2 (1·9 to 4·7) |
| Net benefit (billions, US$) | −2·1 (−3·1 to −1·2) | 2·8 (1·6 to 3·9) | 0·8 (−0·8 to 2·3) |
Data are mean (95% UI). Monetary values presented in 2019 US$. Costs and full income benefits presented without discounting. Benefit–cost ratio, net benefits, and cost per death averted based on discounted costs and benefits. Results reported for primary prevention delivered through health centre-based treatment, and results for additional sensitivity analyses, including for community-based delivery of primary prevention, are reported in the appendix (pp 47-56).
Health centre-based pharyngitis treatment.
Secondary prophylaxis, diagnosis, case management, and cardiac surgery for rheumatic fever and rheumatic heart disease.
Primary, secondary, and tertiary management.
Calculated using costs of scale-up 2021–30 and benefits accrued 2021–90; should be interpreted with caution because strongly dependent on assumed discount rates and inherently uncertain long-term projections of economic indicators.