

@article {7299,
	title = {Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries},
	journal = {BMJ open},
	volume = {4},
	number = {6},
	year = {2014},
	pages = {e003987},
	abstract = {OBJECTIVE: This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. METHODS: We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer{\textquoteright}s perspective, discounted costs and DALYs at 3\% per year and denominated cost in 2012 US dollars. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. RESULTS: Implementation of the IPC in the 10 most cost-effective countries at 15\% population coverage would cost US\$583 million over 3 years (adjusted costs of US\$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15\% coverage would cost an adjusted US\$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US\$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US\$119, US\$181, US\$335, US\$1692 and US\$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. CONCLUSIONS: IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health.},
	keywords = {Health Economics},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2013-003987},
	author = {Marseille, Elliot and Jiwani, Aliya and Raut, Abhishek and Verguet, St{\'e}phane and Walson, Judd and Kahn, James G.}
}
