Table 3 Cost-effectiveness of interventions
Study | Currency | Costs | ICER (Incremental cost-effectiveness ratio) | Cost-effectiveness |
|---|---|---|---|---|
Amarasinghe[30] | 2003 AUD | $16 million saved on IHD treatment | When 100% compliance, $20 subsidy per GP visit $810/DALY averted (all causes) | Very cost-effective |
$18 million saved on stroke treatment | When 50% compliance, $25 subsidy rate, $11,000/DALY averted (all causes) | |||
Cecchini[31] | 2005 US$ | Â | At 20 yrs, compared to control - Int1 China $7785/DALY averted, India $6151/DALY averted; Int2 China $71/DALY averted, India $952/DALY averted; Int3 China $7188/DALY averted, India $15552/DALY averted; Int4 China cost-saving, India cost-saving | Int 1 Cost-effective in China, not cost-effective in India; Int 2 very cost-effective in China, cost-effective in India; Int 3 very cost-effective in China, not cost-effective in India; Int4 very cost-effective |
Cobiac[32] | 2003 AUD | Â | Compared with current best practice: | Int1-5, 7-8 very cost-effective; Int 6 not cost-effective |
Int1 Dominant; Int2 Dominant; Int3 $3300/DALY averted; Int4 $6800/DALY averted; Int5 $10,000/DALY averted; Int6 $190,000/DALY averted; Int7 Dominant; Int8 $14000/DALY averted | ||||
Cobiac[33] | 2003 AUD |  | Compared to ‘Do nothing’ | Cost-effective |
Int1 $130,000/DALY averted; Int2 $140,000/DALY averted | ||||
Cobiac[34] | 2003 AUD |  | Compared to ‘Do nothing’ (medians) | Int 1-5 very cost-effective; Int 6 cost-effective |
Int1 Dominant; Int2 Dominant; Int3 $3000/DALY averted; Int4 $11,000/DALY averted; Int5 $18,000/DALY averted; Int6 $79000/DALY averted | ||||
Cobiac[35] | 2003 AUD |  | Compared to ‘Do nothing’ : | Int1 and 2 cost-effective; Int 3 not cost-effective; Int4 unlikely to be cost-effective |
Int1 Dominant; Int2 Dominant; Int3 $260000-$390000/DALY averted; Int4 160000-250000/DALY averted | ||||
Cobiac[36] | 2003 AUD |  | Compared to ‘Do nothing’, at 1 yr (assumed 50% decay in effectiveness after implementation): | Int 1-4 very cost-effective; Int 5 and 6 not cost-effective; Int7 cost-effective |
Int1 Dominant; Int2 $8600/DALY averted; Int3 $12000/DALY averted; Int4 $27000/DALY averted; Int5 $280000/DALY averted; Int6 $950000/DALY averted; Int7 $84000/DALY averted | ||||
Cobiac[37] | 2008 AUD |  | Compared to ‘Do nothing’: | Int1 and 2 very cost-effective; Int 3 and 4 cost-effective; Int 5 not cost-effective |
Int1 Dominant (Dominant to Dominant); Int2 $44000/DALY averted ($19000-$100000/DALY averted); Int3 $1000000/DALY averted ($610000-2400000/DALY averted); Int4 $1400000/DALY averted ($960000-2500000/DALY averted); Int5 $3200000/DALY averted ($1900000-5900000/DALY averted) | ||||
Dalziel[38] | 2003 AUD | Â | Compared to control: $46/QALY to $19800/QALY for all 8 interventions | Very cost-effective |
Dalziel[39] | 2001 NZ$ | Â | Compared to control, at 40 year time point: | Very cost-effective |
For intervention implemented 1 year, effects lasting 4 years: $2053/QALY gained; Effects lasting 5 years: $1663/QALY gained; Effects lasting 10 years: $1160/QALY gained | ||||
Elley[40] | 2001 NZ$ | Â | At 12 months, compared to control: $1756 for 1 adult to move from a sedentary to active state; Program cost $170.45 per patient per year | Inconclusive |
Forster[41] | 2003 AUD | Â | Compared to control: Int 1 $12000/DALY averted (cost saving -$68000/DALY averted); Int 2 $13000/DALY averted (cost saving -$130000/DALY averted) | Very cost-effective |
Ha[42] | 2007 VND | Int1 1945002/DALY averted; Int2 12324059/DALY averted; Int3 2416075/DALY averted; Int4 2211140/DALY | Compared to control: All interventions Dominated | Very cost-effective |
Higashi[43] | 2006 VND | 1742000/DALY averted (I$ 543/DALY averted) physician advice | Compared to control: All pharmaceuticals dominated by physician advice. | Physician advice very cost-effective; pharmaceutical interventions not cost-effective |
Higashi[44] | 2006 VND | Â | Compared to control: All interventions dominate | Very cost-effective |
Int1 8600VND/DALY averted (3400, 20100);Int2 4200VND/DALY averted (1700, 9900); Int3 2900VND/DALY averted (1100, 6700); Int4 500VND/DALY averted (300,1200); Int5 78300VND/DALY averted (43700, 176300); Int6 67900VND/DALY averted (28200-332000); Int7 336800VND/DALY averted (169300, 822900) | ||||
Jafar[45] | 2007 US$ | Â | Compared to no intervention: Int 1$23/mmHg ($7-$101/mmHg); Int 2 Dominated (dominated to 730/mmHg); Int 3 $206/mmHg (Dominated to $807/mmHg) | Inconclusive |
Joo[46] | 2007 US$ | Public health int $976/person to reach target weight; Remote int. $1637/person to reach target weight | Â | Inconclusive |
Murray[47] | I$ 2000 | Int 1 $37/DALY averted; Int2$19/DALY averted; Int3 $14/DALY averted; Int4 $17/DALY averted (personal interventions $36-90/DALY) | Int 2 compared to Int3 $14/DALY averted; (Int 2 to Int 4) compared to (Int 3 to Int4) $20/DALY averted | Very cost-effective |
Navarro[48] | 2005-2006 AUD |  | Compared to ‘Do nothing’: 10% increase in screening rate $217/risky drinker reducing alcohol consumption; 20% increase $205; 100% increase $216 | Inconclusive |
Oldenburg[25] | 1990 AUD | Int3 (only intervention which reached the maintenance stage of behavioural intervention) $22.06/unit of CVD risk reduction | Â | Inconclusive |
Ortegon[49] | I$ 2005 | Â | Compared to no intervention: Int1 $116/DALY averted; Int2 $87/DALY averted; Int3 $187/DALY averted; Int4 $162/DALY averted; Int5 $195/DALY averted; Int6 $958/DALY averted; Int7 $1179/DALY averted; Int8 $197/DALY averted; Int9 $901991/DALY averted; Int10 $191/DALY averted | Int 1-5, 8, 10 very cost-effective; Int6 not cost-effective in Myanmar, cost-effective in Bangladesh, Dem Rep Korea, India, very cost-effective Bhutan, Maldives; Int7 not cost-effective in Myanmar or Nepal, cost-effective in Bangladesh, India, Dem Rep Korea, very cost-effective in Bhutan and Maldives; Int9 not cost-effective |
Pritchard[28] | 1993-4 AUD | Â | Compared to control: Int 1 $9.76/extra kg lost (12% reduction in BP); Int 2 $7.30/extra kg lost (7% reduction in BP) | Inconclusive |
Ranson[29] | 1997 USD | Â | Compared to control: Int 1: East Asia & Pacific $2-50/DALY averted, South Asia $1-33/DALY averted; Int 2: East Asia & Pacific $25-510/DALY averted, South Asia $16-326/DALY averted | Int 1 Very cost-effective; Int 2 cost-effective to very cost-effective |
Sacks[50] | 2003 AUD |  | Compared to ‘Do nothing’: Int 1 Dominant ($30/DALY averted, 95% CI 20-40); Int 2 Dominant ($1800/DALY averted, 95% CI 1360-2170) | Very cost-effective |
Salkeld[27] | 1994 AUD | Â | Compared to routine care, both interventions not cost-effective or effective (no significant change in risk); Except for Int 1 for high risk males $39440/LYS and $29574/QALY | Int 1 for high risk males very cost-effective |
Shearer[51] | 2003 AUD | Brief advice: $1910/quitter ($1273-3820); Telephone counselling: $606/quitter ($505-757) | Â | Inconclusive |
Snowdon[52] | 2006 Fiji dollar (FJD) | At 1 year Most effective: Tonga - Ban on sale of all fatty meats TOP 30974/6.61 deaths averted; Fiji - cool storage available at all markets | Â | Inconclusive |
2006 Tongan Pa'anga (TOP) | FJD1600149/65.54 deaths averted; Lowest costs: Tonga - removal of licensing requirements for roadside vendors selling local produce TOP0/death averted; Fiji- import duty (15%) added to all oils FJD396/17.43 deaths averted | |||
Zomer[53] | 2012 AUD | 100% compliance: $50,000/LYS | Â | Very cost-effective |