Table 2

Cost per DALY averted estimates relating to the predominantly used preventive chemotherapy strategies

Study, publication yearIntervention and settingApproach used to estimate the effectiveness and time horizonAssumed average costs of preventive chemotherapyAverage cost-effectiveness ratio per DALY avertedCost year
Lymphatic filariasis:
Remme et al (DCP2), 2006102Annual 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)UnclearUS$29 within the control scenario and between US$4.40–8.10 within two elimination scenariosUnclear
Turner et al, 201757Annual 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), 2006102Annual 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$7Unclear
Coffeng et al, 2013103Annual 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 treatmentUS$27Nominal values
Turner et al, 2014104Annual 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), 20067Annual mass school-based treatment—hypothetical setting (intervention time frame: unclear)Back of the envelope (time horizon: unclear)Not statedUS$336–692 (note that this at times incorrectly quoted as US$3.36–6.92 within the report105Unclear
GiveWell, 2011106Annual 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$28.19–70.48Unclear
Lo et al, 201632Annual 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, 1997107Mass 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 ChinaUS$8Unclear
Miguel and Kremer, 2004108Biannual 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), 20067Annual mass school-based treatment—hypothetical setting (intervention time frame: unclear)Back of the envelope (time horizon: unclear)Not statedUS$326.43 (note that within the report the results were reported as US$3.41 but there were errors within the calculation105Unclear
GiveWell, 2011106Annual 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 treatmentUS$82.54Unclear
Lo et al, 201632Annual 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, 201859Annual 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 reportedUS$125 (95% uncertainty range: 65–231)2013
Schistosomiasis and STH:
Warren et al (DCP1), 1993109Annual 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$6–33Unclear
Miguel and Kremer, 2004108Annual mass school-based treatment for schistosomiasis and biannual mass school-based treatment for STH—given within a project in Kenya (intervention time frame: 1 year)Based on project data (time horizon: 1 year)US$ 0.49 per pupil per year (including drug costs)US$5 (99% of the benefit was due to averted schistosomiasis)Unclear
Lo et al, 201531Annual 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.