Background
Methods
Impact modelling
Interventions
Disease | Label | Interventions [22] |
---|---|---|
Cervical cancer | C1a | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls |
C1b | Prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | |
C1c | Prevention of cervical cancer by screening women aged 30–49 through Pap smear (cervical cytology) every 3–5 years linked with timely treatment of pre-cancerous lesions | |
C1d | Prevention of cervical cancer by screening women aged 30–49 through human papillomavirus test every 5 years linked with timely treatment of pre-cancerous lesions | |
C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | |
C1f | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through Pap smear (cervical cytology) every 3–5 years linked with timely treatment of pre-cancerous lesions | |
C1g | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and Prevention of cervical cancer by screening women aged 30–49 through human papillomavirus test every 5 years linked with timely treatment of pre-cancerous lesions | |
C1h | Treatment of cervical cancer stages I and II with either surgery or radiotherapy ± chemotherapy | |
C1i | Basic palliative care for cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | |
Breast cancer | C2a | Treatment of breast cancer stages I and II with surgery ± systemic therapy |
C2b | Screening with mammography (once every 2 years for women aged 50–69 years) linked with timely diagnosis and treatment of breast cancer | |
C2c | Basic palliative care for cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | |
Colorectal cancer | C3a | Treatment of colorectal cancer stages I and II with surgery ± chemotherapy and radiotherapy |
C3b | Basic palliative care for cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines |
Estimation of HLYs
Cervical cancer
Breast cancer
Colorectal cancer
Data sources for state-transition rates
Intervention effect sizes
Disability weights
Cervical cancer
Breast cancer
Colorectal cancer
Incidence
Intervention costing
Results
Label | Description of the intervention | Pop° coverage (%) | Costs per 10 million population (million I$ 2010) | HLY per 10 million population (undiscounted) | Average cost-effectiveness ratio (ACER) | Incremental cost-effectiveness ratio (ICER) |
---|---|---|---|---|---|---|
CVC_C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | 50 | 396 | 4,541,842 | 87 | 87 |
CRC_C3a | Treatment of colorectal cancer stages I and II with surgery ± chemotherapy and radiotherapy | 95 | 207 | 870,417 | 238 | 238 |
BRC_C2a | Treatment of breast cancer stages I and II with surgery ± systemic therapy | 95 | 206 | 816,200 | 252 | 252 |
CVC_C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | 80 | 549 | 5,106,391 | 108 | 272 |
CVC_C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | 95 | 626 | 5,262,580 | 119 | 491 |
BRC_C2b | Screening with mammography (once every 2 years for women aged 50–69 years) linked with timely diagnosis and treatment of breast cancer | 95 | 1056 | 1,627,782 | 649 | 1048 |
BRC_C2c | Basic palliative care for breast cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 193 | 22,877 | 8434 | 8434 |
CRC_C3b | Basic palliative care for colorectal cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 158 | 5944 | 26,571 | 26,571 |
CVC_C1i | Basic palliative care for cervical cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 156 | 5262 | 29,704 | 29,704 |
Label | Description of the intervention | Pop° coverage (%) | Costs per 10 million population (I$ 2010) | HLY per 10 million population (undiscounted) | Average cost-effectiveness ratio (ACER) | Incremental cost-effectiveness ratio (ICER) |
---|---|---|---|---|---|---|
CVC_C1a | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls | 50 | 146 | 5,215,136 | 28 | 28 |
CVC_C1a | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls | 80 | 190 | 6,773,262 | 28 | 28 |
CVC_C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | 80 | 1163 | 30,421,065 | 38 | 41 |
BRC_C2a | Treatment of breast cancer stages I and II with surgery ± systemic therapy | 95 | 157 | 1,389,662 | 113 | 113 |
CVC_C1e | Vaccination against human papillomavirus (two doses) of 9–13-year-old girls and prevention of cervical cancer by screening women aged 30–49 through visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions | 95 | 1362 | 31,554,286 | 43 | 175 |
CRC_C3a | Treatment of colorectal cancer stages I and II with surgery ± chemotherapy and radiotherapy | 95 | 136 | 626,379 | 217 | 217 |
BRC_C2b | Screening with mammography (once every 2 years for women aged 50–69 years) linked with timely diagnosis and treatment of breast cancer | 95 | 1307 | 2,697,617 | 485 | 485 |
BRC_C2c | Basic palliative care for breast cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 171 | 56,749 | 3009 | 3009 |
CVC_C1i | Basic palliative care for cervical cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 161 | 48,488 | 3316 | 3316 |
CRC_C3b | Basic palliative care for colorectal cancer: home-based and hospital care with multi-disciplinary team and access to opiates and essential supportive medicines | 95 | 113 | 5602 | 20,117 | 20,117 |
Diseases | Total costs (per 10 million population) | Costs (%) | ||
---|---|---|---|---|
Southeast Asia | Eastern sub-Saharan Africa | Southeast Asia | Eastern sub-Saharan Africa | |
CVC | 781,881,006 | 1,522,549,019 | 30 | 45 |
BRC | 1,454,645,503 | 1,635,269,849 | 56 | 48 |
CRC | 364,949,796 | 248,737,875 | 14 | 7 |
Total costs (per 10 million population) | 2,601,476,305 | 3,406,556,743 | ||
Total undiscounted HLY (per 10 million population) | 8,611,060 | 36,378,783 | ||
ACER | 302.11 | 93.64 | ||
Total discounted HLY (per 10 million population) | 1,830,047 | 4,938,728 |