Cost-effectiveness Evidence on Prevention, Control, and Treatment of NCDs

Cost-effectiveness Evidence on Prevention, Control, and Treatment of NCDs

Policy makers and others use cost-effectiveness studies (among others) to help decide on interventions to improve public health. Cost-effectiveness analysis (CEA) compares the costs of the intervention to the resulting change in health.14

A systematic review on CEA evidence to address NCDs in low- and middle-income countries found few of them have been analyzed to determine how much health improvement can be gained per dollar spent(Mulligan et al. 2006). Since then, more efforts have been undertaken both to review the available evidence and to build new evidence, partly through modeling approaches (rather than evidence from actual interventions).

World Bank (2006) broadly addressed many health conditions and attempted to determine costeffectiveness of interventions in low- and middle-income countries. In the following year, the World Bank (Adeyi et al. 2007) published a book containing a comprehensive review of evidence based on costeffective interventions. WHO has developed its approach on generalized CEA via its CHOICE project.15

CHOICE reports results for 14 global subregions, including the South-East Asian Region of WHO.16 Building on work for both World Bank (2006) and CHOICE, a 2007 Lancet series on chronic disease has calculated the cost-effectiveness both for selected population-based interventions (Asaria et al. 2007) and for drug-based reduction of individual susceptibility to CVD among high-risk individuals (Lim et al. 2007).

The results of all these studies noted here form the basis of the findings in the rest of this

chapter. While there will probably always remain a certain tension in the debate between prevention and treatment of chronic NCDs, most experts would agree that a comprehensive approach that is balanced across all levels and facets of intervention is the only appropriate way to tackle them.