Cost-Effective Interventions

Interventions are actions taken by or for individuals to reduce the risk, duration, or severity of adverse health conditions. Interventions may be population-based or personal.

DCP2 and GBD present what we know about which health interventions work for a comprehensive range of diseases, injuries, and disabilities in many different contexts. A large share of the disease burden in low- and middle-income countries is attributable to diseases and conditions for which cost-effective interventions are already known and feasible. Selecting the right intervention for a given disease and context matters a great deal. The tools on this page are designed to aid the task.

DCP2 and GBD demonstrate how decision makers could use cost-effectiveness information in combination with information on disease prevalence and avertable illness to determine which interventions should be extended and which ones should be questioned. If developing countries scale up interventions and extend health care services that are cost-effective, the impact on the disease burden could be substantial.

Select Criteria

Disease / Condition Setting Type Objective Target population

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Condition Intervention Intervention type Intervention description Intervention setting Objective Target population Cost effectiveness (US$/DALY) Cost effectiveness estimate (US$) Cost effectiveness range (US$/DALY) Number of DALYs averted (hundreds) Number of deaths averted (hundreds) Quality of cost-effectiveness analysis evidence
Cervical cancer Chemoradiation therapy Personal Cisplatin-based chemoradiation regimens on the basis of published and estimated survival. Local or district hospital secondary prevention Adults, Women of childbearing age, Adolescents and adults - 337-31,400 per LYS (USA) - - - 1
Colorectal cancer Chemotherapy Personal Adjuvant chemotherapy for stage three colon cancer Local or district hospital secondary prevention Adults, Women of childbearing age - 3,000-7,000 per YLS (High-income countries) - - - 1
Breast cancer Chemotherapy and/or tamoxifen Personal Tamoxifen and/or chemotherapy for 45-year-old premenopausal women with early-stage breast cancer; for nodepositive, node-negative, estrogenreceptor-positive, and estrogenreceptor-negative patients Local or district hospital secondary prevention Adults - 12,820-171,700 (USA) - - - 3
Breast cancer Clinical breast exam Personal Examination of the breast performed by doctors or other trained health care professionals; annually, biennially, or five yearly; for women ages 40-60 Clinic secondary prevention Adults - 7125-9907 per death prevented (India); 522-722 per LYS (India) - - - 4
Colorectal cancer Colonoscopy every 10 years Personal Colonoscopy allows the physician to look inside the entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. The procedure is used to look for early signs of cancer in the colon an Local or district hospital secondary prevention Adults, Women of childbearing age - 9309-22,672 per YLS (USA) - - - 2
Cervical cancer Conventional or liquidbased cytology testing Personal Conventional cytology using the Papanicolaou (Pap) smear and HPV testing every 1 to 10 years; or Liquid-based cytology using the Papanicolaou (Pap) smear and HPV testing every 1 to 5 years Local or district hospital secondary prevention Adults, Women of childbearing age, Adolescents and adults - 126,500 (USA); 162,400 (Thailand) - - - 2
Colorectal cancer Double-contrast barium enema every 5 years Personal A series of x-rays of the colon and rectum taken after the patient is given an enema, followed by an injection of air. The barium outlines the intestines on the x-rays, allowing many abnormal growths to be visible. This is conducted every 5 years. Local or district hospital secondary prevention Adults, Women of childbearing age - 11,503-26,393 per YLS (USA) - - - 2
Lung cancer Early detection screening Population Screening of high-risk individuals, such as current and former smokers, for lung cancer using helical computed tomography Local or district hospital population-oriented medical intervention Adults, Women of childbearing age, Pregnant women - 20,000-100,000 per YLS (USA) - - - 3
Colorectal cancer Fecal occult blood test Population Fecal occult blood test to check stool samples for traces of blood; conducted annually or biennially Local or district hospital secondary prevention Adults, Women of childbearing age - 3,200-12,100 per YLS (Highincome countries) - - - 2
Colorectal cancer Flexible sigmoidoscopy every 5 years with or without fecal occult blood test Personal Flexible sigmoidoscopy enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon; fecal occult blood test checks stool samples for traces of blood. Local or district hospital secondary prevention Adults, Women of childbearing age - 18,700-25,954 (USA) - - - 2
Cervical cancer Nationwide Pap screening program based on fiveyear intervals Personal Nationwide Pap screening program based on five-year intervals Local or district hospital secondary prevention Adults, Women of childbearing age, Adolescents and adults - 769 per YLS (Vietnam) - - - 2
Cervical cancer One-visit VIA Personal Cervix is viewed after the application of an acetic acid solution; screening and treatment conducted during the same visit Local or district hospital secondary prevention Adults, Women of childbearing age, Adolescents and adults - 56 per YLS (Brazil); 54 per YLS (Madagascar); 43 per YLS (Zimbabwe) - - - 1
Colorectal cancer Radiation therapy Personal Preoperative radiation therapy for rectal cancer patients; with varying rates of recurrence and survival advantage with and without radiation treatment Local or district hospital secondary prevention Adults, Women of childbearing age - 908-15,228 per YLS (Sweden) - - - 1
Breast cancer Radiation therapy Personal Radiation therapy following mastectomy and chemotherapy for node-positive breast cancer in premenopausal women Local or district hospital secondary prevention Adults - 23,300-44,000 per QALY (USA) - - - 2
Breast cancer Screening mammography Personal Examination of the breasts performed by compressing the breast firmly between a plastic plate and an X-ray cassette that contains special X-ray film; one lifetime or biennially Clinic secondary prevention Adults - 12,262-24,493 per death prevented (India); 902-1846 per LYS (India); 2450-14,790a per YLS (Europe); 28,600-47,900 (USA) - - - 2 (USA, Europe); 4 (India)
Cervical cancer Three-visit cytology Personal Cytology sample obtained during the first visit, colposcopy for screen-positive women conducted during the second visit, and treatment provided during the third visit Local or district hospital secondary prevention Adults - 589 per YLS (Brazil); 379 per YLS (Madagascar); 331 per YLS (Zimbabwe) - - - 1
Cervical cancer Two-visit HPV testing Personal HPV DNA testing during the first visit followed by treatment of screen-positive women during the second visit Local or district hospital secondary prevention Adults, Women of childbearing age, Adolescents and adults - 122 per YLS (Brazil); 167 per YLS (Madagascar); 41 per YLS (South Africa); 117 per YLS (Zimbabwe) - - - 1

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