Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Abstract

Objective To provide a systematic review of economic evaluations that has been conducted for onchocerciasis interventions, to summarise current key knowledge and to identify research gaps. Method A systematic review of the literature was conducted on the 8th of August 2018 using the PubMed ( MEDLINE ) and ISI Web of Science electronic databases. No date or language stipulations were applied to the searches. Results We identified 14 primary studies reporting the results of economic evaluations of onchocerciasis interventions, seven of which were cost‐effectiveness analyses. The studies identified used a variety of different approaches to estimate the costs of the investigated interventions/programmes. Originally, the studies only quantified the benefits associated with preventing blindness. Gradually, methods improved and also captured onchocerciasis‐associated skin disease. Studies found that eliminating onchocerciasis would generate billions in economic benefits. The majority of the cost‐effectiveness analyses evaluated annual mass drug administration ( MDA ). The estimated cost per disability‐adjusted life year ( DALY ) averted of annual MDA varies between US $3 and US $30 (cost year variable). Conclusions The cost benefit and cost effectiveness of onchocerciasis interventions have consistently been found to be very favourable. This finding provides strong evidential support for the ongoing efforts to eliminate onchocerciasis from endemic areas. Although these results are very promising, there are several important research gaps that need to be addressed as we move towards the 2020 milestones and beyond.

Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs

“…An overview of the studies is presented in Table 1. Interestingly, there were notably more economic evaluations of schistosomiasis than those identified in previous reviews for other helminth infections of human health importance [15][16][17] .…”

“…The costs of preventive chemotherapy vary across different settings [15][16][17] , both within and between countries. A driver is the size of the targeted population 120-122 .…”

“…The impact of the goal of the intervention The goal of a programme is an important consideration when interpreting economic evaluations 15,17 . Some areas, particularly in Asia, are aiming to move beyond morbidity control and elimination as a public health problem to interruption of transmission 139 (Box 1).…”

Onchocerciasis (river blindness): larva‐induced eczema (onchodermatitis) from an important oculocutaneous tropical disease spilling over into North America and Europe

“…Accordingly, controlling and eliminating onchocerciasis with enhanced onchocerciasis elimination plans are highly desirable. Economic evaluations of onchocerciasis interventions have been favorable …”

Increased cost‐benefit of strengthening onchocerciasis elimination efforts in areas with high onchocerciasis‐associated epilepsy

“…Increased cost-benefit of strengthening onchocerciasis elimination efforts in areas with high onchocerciasis-associated epilepsy Turner et al [1], in their excellent systematic review of economic evaluations of onchocerciasis interventions, estimated the cost per disability-adjusted life year (DALY) averted by annual ivermectin distribution as between US $3 and US $30. Based on these studies, a very little additional benefit was demonstrated with biannual compared to annual ivermectin distribution (only a 3-4% increase in the number of DALY averted, while the cost will increase by 50-60%).…”