Table 1 |
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| Disease burden rank, pharmacoeconomic evidences and their main findings, implications and current listing status | |||
| Rank | Disease | Tanzanian pharmacoeconomic evidence | Main findings, implications and current listing status |
| 1 | HIV/AIDS | HAART for PMTCT [21] | Highly cost-effective intervention with ICER of US$ 162 per DALY averted when compared to sd-NVP, however it is 40% more costly but 5 times more effective |
| ( Listing status: HAART is one of the two options recommended by WHO but not the one being implemented in Tanzania, an area for future research) | |||
| Sd-NVP for PMTCT [24] | (Listing status: Use of Sd-NVP is the old policy which was also based on WHO’s recommendations but currently being phased out in Tanzania) | ||
| 2 | Malaria | ALu for non-severe malaria [26] | A cost-effective drug which saves US$ 22.4 per case averted when compared to amodiaquine. (Listing status: ALu is one of the few artemisinin-based combination therapies recommended by WHO and is the current drug of choice in Tanzania) |
| SP for non-severe malaria [25] | (Listing status: Use of SP was replaced by ALu since 2007 due to parasite resistance but still listed as essential medicine for IPTp) | ||
| SP for IPTi [27] | A cost-effective intervention with ICER of US$ 1.6-12.2 per DALY* averted. SP-IPTi reduces episodes of clinical malaria and anaemia by 30 and 21 percent in areas of moderate to high malaria transmissions, in the first year of life [32]. | ||
| (Listing status: SP-IPTi is a new intervention strategy recommended by WHO since 2010 but not yet adopted in Tanzania) | |||
| 3 | Diarrhoeal diseases | Zinc as adjunct therapy [23] | A highly cost-effective intervention when combined with ORS with ICER of US$ 73 per DALY averted |
| (Listing status: Listed on essential medicine list since 2007, based on WHO’s recommendations) | |||
| 4 | Injury/ Trauma | Tranexamic acid Inj for surgical bleeding and trauma patients [20,29] | A highly cost-effective intervention with ICER of US$ 93 and US$ 48 per life saved for surgical and trauma patients*. TXA reduces number of transfusions by one-third and volume of blood per transfusion by one unit in elective surgery [33]. TXA reduces risks of death by 21% if administered within 3 hrs after injury [34]. |
| (Listing status: Tranexamic acid Inj. was listed recently on WHO’s list of essential medicine but not yet listed in Tanzania) | |||
| 5 | ARI | None | None |
| 6 | TB | Short-course chemotherapy [31] | A highly cost-effective option with ICER of US$ 1–4 per LY saved. Short-course chemotherapy increases cure rate by 25% compared to the long regimens. |
| (Listing status: Listed; Introduced and adopted in Tanzania in mid 1980’s) | |||
| 7 | Prenatal conditions | None | None |
| 8 | Maternal deficiencies | None | None |
| 9 | Nutritional deficiencies | Iron+ Deltaprim to prevent anaemia and malaria in infants [28] | Considered to be a cost-effective intervention, support the evidence shown by SP-IPTi in reduction of both anaemia and malaria |
| (Listing status: Deltaprin (dapsone +pryrimethamine) is not listed as essential medicine in Tanzania | |||
| 10 | CVD and Diabetes | Preventive cardiology [22] | Diuretics, Aspirin+Diuretic and Aspirin+Diuretic+β-blocker are very cost-effective with ICERS of US$ 85, 143 and 317 per DALYS averted. |
| (Listing status : new evidence but these drugs were already listed as essential medicines before the publication of the study) | |||
| 11 | Neoplasms | None | None |
| 12 | Immunisable diseases | Anti-Rabies vaccine [30] | A very cost-effective intervention with ICER of US$ of 27 and 32 per DALY* averted from provider and societal perspectives. |
| (Listing status: New evidence, but the vaccine was already listed as essential medicine before the publication of the study) | |||
* Compared to do nothing, ALu-artemether-lumefantrine, SP- sulphadoxine-pyrimethamine, Sd-Single dose, HAART-Highly active antiretroviral drugs, ORS-Oral rehydration salt, ARI-acute respiratory tract infections, CVD-cardiovascular diseases.
Mori and Robberstad
Mori and Robberstad BMC Medical Informatics and Decision Making 2012 12:110 doi:10.1186/1472-6947-12-110
