Table 2 Summary of the identified cost-benefit analyses and estimates of the economic benefits of interventions

[20]

The economic benefits associated with different rates of scaling-up MDA within the GPELF

Global

50 years

Three different rates of scaling-up the MDA coverage of the GPELF

(i) Prevented potential productivity/income losses

• Extending coverage to all LF endemic areas could generate additional economic benefits through potential gains in worker productivity between US$ 3.4 billion and US$ 14.4 billion and could result in health systems savings of up to US$ 483 million due to averted morbidity management costs.

(i) [98]; (ii) [21, 99]

(ii) Prevented costs to the health system for caring for clinical patients

• Costs are in 2012 US$

[21]

The economic benefit resulting from the MDA provided by the GPELF (2000–2007)

Global

Lifetime of the benefit cohort resulting from the MDA provided between 2000 and 2007

Annual MDA

(i) Prevented medical expenses incurred by patients

• An estimated US$ 24 billion in potential economic benefits will be gained over the lifetime of those treated by the GPELF between 2000 and 2007

(i)^a; (ii)^b; (iii) [99]

(ii) Prevented potential productivity/income losses

• This total amount results from summing the estimated prevented medical expenses incurred by LF patients (US$ 1.4 billion), prevented potential productivity/income losses (US$ 20.4 billion), and prevented costs to the health system (US$ 2.2 billion)

(iii) Prevented costs to the health system resulting for clinical patients

• Costs are in 2005 US$

[22]

The economic benefit resulting from the MDA provided by the GPELF (2000–2014)

Global

Lifetime of the benefit cohort resulting from the MDA provided between 2000 and 2014

Annual MDA

(i) Prevented medical expenses incurred by patients

• An estimated US$ 100.5 billion in potential economic benefits will be gained over the lifetime of those treated by the GPELF between 2000 and 2014 and 36 million clinical LF cases will be averted

(i)^a; (ii)^b; (iii) [21, 99]

(ii) Prevented potential productivity/income losses

• This total amount results from summing the estimated prevented medical expenses incurred by LF patients (US$ 3 billion), prevented potential productivity/income losses (US$ 94 billion), and prevented costs to the health system (US$ 3.5 billion)

(iii) Prevented costs to the health system resulting for clinical patients

• The average lifetime economic benefit to an individual with averted clinical disease was estimated to be US$ 2095

• Costs are in 2014 US$

[100]

The economic benefit of MDA in India

India

11 years (based on the average number of years of productive life lost)

Annual MDA

(i) Prevented medical expenses incurred by patients

• The economic benefit accrued by averting a chronic case was projected to be US$ 40.83 per year

(i) [28]; (ii) [28]

(ii) Prevented potential productivity/income losses

• This included preventing US$39.39 in potential productivity/income losses each year (58.24 working days) and US$ 1.44 in prevented medical expenses

• It was estimated that chronic disease afflicts patients for an average of 11 years of productive life and the total lifetime economic benefit was estimated to be US$ 449.13 per chronic case averted

• Cost year not clearly stated

[23]

Economic benefits of community-based lymphedema management

India

Productive working lifetime of lymphedema patients projected over a 60-year period

Lymphedema Management

(i) Prevented medical expenses incurred by patients

• The estimated long-term economic benefit of the investigated lymphedema management programme was US$ 26.1 million

(i) [101, 102]; (ii) [103]

(ii) Prevented potential productivity/income losses

• This corresponds to an average benefit of US$ 1648 per participant of working age (equivalent to 1258 days of earnings over their lifetime)

• Real wages and real expenditure on medical care were assumed to rise 4% per year

• Costs are in 2008 US$

[21]

The cost-benefit of the MDA provided by the GPELF (2000–2007)

Global

Lifetime of the benefit cohort resulting from the MDA provided between 2000 and 2007

Annual MDA

Benefit-cost ratio

• The study estimated country-specific benefit-cost ratios for years of the GPELF with corresponding treatment cost data [47]

[47]

• Results ranged between 1.64–18.07 when using financial costs, and 0.21–8.59 when using the economic costs (including the donated drugs value)

• The ratios were lower in settings where ivermectin was used (due to its higher economic value)

• Costs are in 2005 US$

[17]

The cost-benefit of the MDA provided by the GPELF (2000–2014)

Global

Lifetime of the benefit cohort resulting from the MDA provided between 2000 and 2014

Annual MDA

Benefit-cost ratio

• The benefit-cost ratios varied depending on what costs were included in the analysis:

[53]

  • Using financial costs: 36 (23–74)

  • Using economic costs- excluding the donated drugs value: 30 (18–63)

  • Using economic costs- including the donated drugs value: 14 (11–18)

• The range is based on the predicted 95% confidence intervals for the treatment delivery costs

• Costs are in 2014 US$

[100]

The cost-benefit of MDA in India

India

11 years for the economic benefits and 6 years for the intervention costs

Annual MDA

Benefit-cost ratio

• Estimated that preventing a chronic LF case has a benefit-cost ratio of 53.4 (not discounted)

[97]

• This is based on an estimated economic benefit of US$ 449.13 per chronic case averted and assumes that the prevention of 1 chronic case (through 6 MDA rounds) costs US$ 8.41

• Cost year not clearly stated

[23]

The cost-benefit of community-based lymphedema management

India

Productive working lifetime of lymphedema patients projected over a 60-year period

Lymphedema management

Benefit-cost ratio

• To implement/operate the community-based lymphedema management programme for 2 years cost between US$ 10.00–12.50 per person [104]

[104]

• An average participant can expect lifetime economic benefits 132–165 times greater than the per-person cost of the programme

• Costs are in 2008 US$