10. Gender Differentials in Health

Table 10.5: Cost-Effectiveness of Selected Interventions Aimed at Conditions Specific to Women or That Affect Women Disproportionately

Cost-Effectiveness of Selected Interventions Aimed at Conditions Specific to Women or That Affect Women Disproportionately
InterventionRegion or countryLower end of rangeUpper end of rangeSource
Maternal conditions
Mother and baby packageLMICsUS$2 per capitaUS$4 per capitaWHO 1997
Mother and baby packageLMICsUS$18 per DALY avertedUS$58 per DALY avertedRaviez, Griffin, and Follmer 1995; World Bank 1993
Mother and baby packageSub-Saharan AfricaUS$77 per DALY avertedUS$151 per DALY avertedChapter 26 of this publication
Mother and baby packageSouth AsiaUS$143 per DALY avertedUS$278 per DALY avertedChapter 26 of this publication
Integral prenatal careUgandaUS$2.26 per pregnant womanUS$6.43 per pregnant womanLevin and others 1999
Iron and folic acid nutritional supplementationLow-income countriesUS$13 per DALY averted in highly anemic pregnant womenn.a.Berman and others 1991
Emergency obstetric careUgandaUS$73 per episodeUS$86 per episodeLevin and others 1999
Cesarean deliveryBoliviaUS$56 per caseUS$104 per caseRosenthal and Percy 1991
Normal deliveryBoliviaUS$11 per caseUS$16 per caseDmytraczenko and others 1998
Postabortion care (dilation and curettage)LMICsUS$4.40 per caseUS$17.19 per caseDayaratna and others 2000
Total health-planning costsSouth AfricaUS$42 per couple-year of protectionUS$44 per couple-year of protectionDayaratna and others 2000
Chlamydia
PreventionDeveloping countries, 1990US$47.98 per DALY averted (noncore target groups)US$651.82 per DALY averted (core target groups)Over and Piot 1993
Prevention (use of condoms)Developing countries,US$3.40 per DALY averted (noncore target groups)US$12.60 per DALY averted (core target groups)Mumford and others 1998
DetectionVarious sites, 1992US$4.38 per pregnant womann.a.Shultz, Schulte, and Berman 1992
TreatmentVarious sites, 1992US$3.82 per pregnant womann.a.Shultz, Schulte, and Berman 1992
Detection and treatmentVarious sites, 1992US$84.92 per adverse outcome averted in low-prevalence context (5 percent)US$307.88 per adverse outcome averted in high prevalence context (20 percent)Shultz, Schulte, and Berman 1992
Neoplasms
Detection of cervical cancerEcuador, 1996US$2.95 per visitUS$3.51 per visit (laboratory costs)Mumford and others 1998
Honduras, 1991US$5.60 per visitUS$12.89 per visitMumford and others 1998
Zimbabwe, 1995US$2.99 per visitUS$3.89 per visitMumford and others 1998
Cervical cytology screeningVietnam, 2000US$725 per discounted DALY avertedn.a.Suba and others 2001
Cervical cytology screeningSouth Africa, 2000US$39 per DALY avertedUS$81 per DALY avertedGoldie and others 2001
Treatment of cervical cancerZimbabwe, 1994US$12.35 per visitUS$95.82 per visitMitchell, Littlefield, and
Mexico, 1994US$52.51 per visitUS$432.42 per visitGutter-1997
Treatment of cervical cancerDeveloped countriesUS$2,384 to US$28,770 per DALY averted based on actual survivaln.a.Rose and Lappas 2000
Treatment of cervical cancerDeveloped countriesUS$308 to US$3,712 per DALY averted based on estimated survivaln.a.Rose and Lappas 2000
Treatment of ovarian cancerThailand, 1995US$234.25 per caseUS$472.27 per caseTintara and Leetanapon 1995
Management of breast cancerBrazil, 1995US$1,667.88 per casen.a.Arredondo, Lockett, and Icaza 1995
Alzheimer's disease and other dementias
Acetylcholinesterase inhibitorsDeveloped countriesUS$13 per hour of caregiver time savedn.a.Marin and others 2003
Developing countriesUS$10 per hour of caregiver time savedn.a.Marin and others 2003
Osteoarthritis
Celecoxib monotherapySwedenUS$1,394 per QALYn.a.Haglund and Svarvar 2000
Rofecoxib monotherapyUnited KingdomUS$2,184 per life year saved (result was sensitive to the use of gastrointestinal protective agents)n.a.Moore and others 2001
Different packages of drugs, including acetaminophen, naproxen, misoprostol, celecoxib, and rofecoxibUnited StatesUS$2,001 to US$2,140 per QALY, depending on the drug combinationn.a.Sigal 2002
Total hip arthroplastyUnited StatesUS$6,893 per QALY for 85-year-old menn.a.Chang, Pellissier, and Hazen 1996
Knee replacementAustraliaUS$6,000 per QALYSigal and others 2004

Source: Authors.

QALY = quality-adjusted life year.

Note: Costs are based in current U.S. dollars as presented in each study. Many studies do not present well-documented data regarding reference period of costs. To avoid mistakes on interpretation, we kept the costs in the currency informed by the authors. n.a. indicates that information is not available.