PMID- 23201550
OWN - NLM
STAT- MEDLINE
DCOM- 20130307
LR  - 20191210
IS  - 1468-2044 (Electronic)
IS  - 0003-9888 (Linking)
VI  - 98
IP  - 2
DP  - 2013 Feb
TI  - The cost effectiveness of treating paediatric cancer in low-income and 
      middle-income countries: a case-study approach using acute lymphocytic leukaemia 
      in Brazil and Burkitt lymphoma in Malawi.
PG  - 155-60
LID - 10.1136/archdischild-2011-301419 [doi]
AB  - Approximately 90% of children with cancer reside in low-income and middle-income 
      countries (LMIC) where healthcare resources are scarce and allocation decisions 
      difficult. The cost effectiveness of treating childhood cancers in these settings 
      is unknown. The objective of the present work was to determine cost-effectiveness 
      thresholds for common paediatric cancers using acute lymphoblastic leukaemia 
      (ALL) in Brazil and Burkitt lymphoma (BL) in Malawi as examples. 
      Disability-adjusted life years (DALYs) prevented by treatment were compared to 
      the gross domestic product (GDP) per capita of each country to define 
      cost-effectiveness thresholds using WHO-CHOICE ('CHOosing Interventions that are 
      Cost-Effective') guidelines. The case examples were selected due to the data 
      available and because ALL and BL both have the potential to yield significant 
      health gains at a low cost per patient treated. The key findings were as follows: 
      the 3:1 cost/DALY prevented to GDP/capita ratio for ALL in Brazil was US 
      $771,225; expenditures below this threshold were cost effective. Costs below US 
      $257,075 (1:1 ratio) were considered very cost effective. Analogous thresholds 
      for BL in Malawi were US $42,729 and US $14,243. Actual costs were far less. In 
      Brazil, US $16,700 was spent to treat each patient while in Malawi total drug 
      costs were less than US $50 per child. In summary, treatment of certain 
      paediatric cancers in LMIC is very cost effective. Future research should 
      evaluate actual treatment and infrastructure expenditures to help guide 
      policymakers.
FAU - Bhakta, Nickhill
AU  - Bhakta N
AD  - Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, California 90027, 
      USA. nbhakta@alumni.brown.edu
FAU - Martiniuk, Alexandra L C
AU  - Martiniuk AL
FAU - Gupta, Sumit
AU  - Gupta S
FAU - Howard, Scott C
AU  - Howard SC
LA  - eng
GR  - CA 21765/CA/NCI NIH HHS/United States
GR  - Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20121130
PL  - England
TA  - Arch Dis Child
JT  - Archives of disease in childhood
JID - 0372434
SB  - IM
MH  - Adolescent
MH  - Brazil
MH  - Burkitt Lymphoma/drug therapy/*economics
MH  - Child
MH  - Child, Preschool
MH  - Cost-Benefit Analysis
MH  - Developing Countries
MH  - Health Care Costs
MH  - Humans
MH  - Income
MH  - Infant
MH  - Leukemia, Lymphoid/drug therapy/*economics
MH  - Malawi
MH  - Outcome Assessment, Health Care
MH  - Quality-Adjusted Life Years
MH  - Treatment Outcome
EDAT- 2012/12/04 06:00
MHDA- 2013/03/08 06:00
CRDT- 2012/12/04 06:00
PHST- 2012/12/04 06:00 [entrez]
PHST- 2012/12/04 06:00 [pubmed]
PHST- 2013/03/08 06:00 [medline]
AID - archdischild-2011-301419 [pii]
AID - 10.1136/archdischild-2011-301419 [doi]
PST - ppublish
SO  - Arch Dis Child. 2013 Feb;98(2):155-60. doi: 10.1136/archdischild-2011-301419. 
      Epub 2012 Nov 30.