Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact email@example.com.
Cost Per Daly Averted in Low, Middle and High Income Countries: Evidence from Global Burden of Disease Study to Estimate the Cost Effectiveness Thresholds
16 Pages Posted: 18 Jul 2019More...
Background: Determining the cost-effectiveness thresholds for healthcare interventions has been an important challenge for policymakers, especially in low and middle income countries. The aim of this study was to estimate the cost per DALY averted for countries with different level of Health Development Index (HDI) and Gross Domestic Product (GDP).
Methods: The data about disability-adjusted life-years (DALYs), per capita health expenditure (HE), HDI, and GDP per capita were extracted for 176 countries during the years 2000 to 2016. Panel regression analysis was performed to explore the correlation between DALY and HE per capita. The results of the regression models were used to calculate the cost per DALY averted for each country.
Findings: ASR DALY (DALY per 100,000 population) had a non-linear inverse correlation with HE per capita, and a linear inverse correlation with HDI. One percent increase in HE per capita was associated with an average of 0.28, 0.24, 0.18 and 0.27 percent decrease in the ASR DALY in low HDI, medium HDI, high HDI and very high HDI countries respectively. The estimated cost per DALY averted was $998, $6,522, $23,782, and $69,499 in low HDI, medium HDI, high HDI and very high HDI countries respectively.
Interpretation: This study suggests that the cost-effectiveness thresholds for healthcare interventions might be less than a GDP per capita in low and medium HDI countries and between one and two GDP per capita in high and very high HDI countries.
Funding Statement: The authors stated "There is no funding."
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: Not Required.
Keywords: DALY, HDI, GDP per capita, Health expenditure
Suggested Citation: Suggested Citation