Cost Effectiveness of Other Personal Interventions| Condition | Intervention | Intervention description | Intervention setting | Objective | Target population | Cost-effectiveness estimate (US$)a | Quality of CEA evidenceb |
| Breast cancer | Clinical breast exam | Examination of the breast performed by doctors or other trained health care professionals; annually, biennially, or every five years; for women ages 40-60 | Clinic | Secondary prevention | Women ages 40-60 | 7125-9907 per death prevented (India); 522-722 per LYS (India) | 4 |
| Breast cancer | Screening mammography | 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 | Women ages 40-70 | 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) |
| Breast cancer | Chemotherapy and/or tamoxifen | Tamoxifen and/or chemotherapy for 45-year-old premenopausal women with early stage breast cancer; for node-positive, node-negative, estrogen-receptor-positive, and estrogen-receptor-negative patients | District hospital | Secondary prevention | Women age 45 | 12,820-171,700 (USA) | 3 |
| Breast cancer | Radiation therapy | Radiation therapy following mastectomy and chemotherapy for node-positive breast cancer in premenopausal women | District hospital | Secondary prevention | Premenopausal women | 23,300-44,000 per QALY (USA) | 2 |
| Cervical cancer | Nationwide Pap screening program based on five-year intervals | Nationwide Pap screening program based on five-year intervals | District hospital | Secondary prevention | Adult women | 769 per YLS (Vietnam) | 2 |
| Cervical cancer | Conventional or liquid-based cytology testing | 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 | District hospital | Secondary prevention | Adult women | 126,500 (USA); 162,400 | 2 |
| Cervical cancer | Two-visit HPV testing | HPV DNA testing during the first visit followed by treatment of screen-positive women during the second visit | District hospital | Secondary prevention | Adult women | 122 per YLS (Brazil); 167 per YLS (Madagascar); 41 per YLS (South Africa); 117 per YLS (Zimbabwe) | 1 |
| Cervical cancer | One-visit VIA | Cervix is viewed after the application of an acetic acid solution; screening and treatment conducted during the same visit | District hospital | Secondary prevention | Women age 35-42 | 56 per YLS (Brazil); 54 per YLS (Madagascar); 43 per YLS (Zimbabwe) | 1 |
| Cervical cancer | Three-visit cytology | Cytology sample obtained during the first visit, colposcopy for screen-positive women conducted during the second visit, and treatment provided during the third visit | District hospital | Secondary prevention | Women age 35-48 | 589 per YLS (Brazil); 379 per YLS (Madagascar); 331 per YLS (Zimbabwe) | 1 |
| Cervical cancer | Chemoradiation therapy | Cisplatin-based chemoradiation regimens on the basis of published and estimated survival. | District hospital | Secondary prevention | Adult women | 337-31,400 per LYS (USA) | 1 |
| Chronic obstructive pulmonary disease | Inhaled medication | Inhaled ipratroprium bromide or corticosteroid such as fluticasone propionate | Clinic/district hospital | Palliation | Adults | 7800-13,400 per QALY (High-income countries) | 1 |
| Chronic obstructive pulmonary disease | A-1 antitrypsin augmentation therapy | Intravenous treatment of chronic obstructive pulmonary disease related to severe deficiency; ranges with age and efficacy | Clinic/district hospital | Palliation | Adults | 14,400-215,000 per QALY (High-income countries) | 1 |
| Chronic obstructive pulmonary disease, asthma, and cardiovascular disease | Mechanical ventilation or oxygen therapy | Mechanical ventilation with inspiratory support, invasive respiration in intensive care unit, or long-term home oxygen therapy | Clinic/district hospital | Palliation | Adults | 15,000-19,000 per YLS (High-income countries); 32,350-47,850 per QALY (High-income countries) | 1 |
| Colorectal cancer | Flexible sigmoidoscopy every 5 years with or without fecal occult blood test | 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. | District hospital | Secondary prevention | Adults | 18,700-25,954 (USA) | 2 |
| Colorectal cancer | Double-contrast barium enema every 5 years | 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. | District hospital | Secondary prevention | Adults | 11,503-26,393 per YLS (USA) | 2 |
| Colorectal cancer | Colonoscopy every 10 years | 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 and rectum. | District hospital | Secondary prevention | Adults | 9309-22,672 per YLS (USA) | 2 |
| Colorectal cancer | Chemotherapy | Adjuvant chemotherapy for stage three colon cancer | District hospital | Secondary prevention | Adults | 3,000-7,000 per YLS (High-income countries) | 1 |
| Colorectal cancer | Radiation therapy | Preoperative radiation therapy for rectal cancer patients; with varying rates of recurrence and survival advantage with and without radiation treatment | District hospital | Secondary prevention | Adults | 908-15,228 per YLS (Sweden) | 1 |
| Diabetes | Smoking cessation | Counseling and medication such as the nicotine patch | Clinic | Primary prevention | Adolescents and adults | 870 per QALY (EAP); 1,170 per QALY (ECA); 1,450 per QALY (LAC); 1,230 per QALY (MNA); 730 per QALY (SAR); 660 per QALY (SSA) | 5 |
| Diabetes | Annual eye examination | Dilated eye examination to detect proliferative diabetic retinopathy and macular edema followed by appropriate photocoagulation therapy to prevent blindness | Clinic | Secondary prevention | Adults | 420 per QALY (EAP); 560 per QALY (ECA); 700 per QALY (LAC); 590 per QALY (MNA); 350 per QALY (SAR); 320 per QALY (SSA) | 5 |
| Diabetes | ACE inhibitor | ACE inhibitors for blood pressure control | Clinic | Secondary prevention | Adults | 620 per QALY (EAP); 830 per QALY (ECA); 1,020 per QALY (LAC); 870 per QALY (MNA); 510 per QALY (SAR); 460 per QALY (SSA) | 5 |
| Diabetes | Metformin intervention for preventing type 2 diabetes | Metformin therapy for preventing type 2 diabetes among people at high risk, such as those with prediabetes | Clinic | Primary prevention | Adults | 2,180 per QALY (EAP); 2,930 per QALY (ECA); 3,630 per QALY (LAC); 3,080 per QALY (MNA); 1,820 per QALY (SAR); 1,640 per QALY (SSA) | 5 |
| Diabetes | Cholesterol control | Cholesterol control for people with total cholesterol higher than 200 milligrams/deciliter | Clinic | Secondary prevention | Adults | 4,420 per QALY (EAP); 5,940 per QALY (ECA); 7,350 per QALY (LAC); 6,240 per QALY (MNA); 3,680 per QALY (SAR); 3,330 per QALY (SSA) | 5 |
| Diabetes | Intensive glycemic control | Intensive glucose control to lower the level of glucose in the person with diabetes to a level close to that of a person without diabetes, for people with HbA1c higher than 8 percent, in order to prevent or delay long-term diabetes complications | Clinic | Secondary prevention | Adults | 2,410 per QALY (EAP); 3,230 per QALY (ECA); 4,000 per QALY (LAC); 3,400 per QALY (MNA); 2,000 per QALY (SAR); 1,810 per QALY (SSA) | 5 |
| Kidney disease | Hemodialysis | Most common method used to treat advanced and permanent kidney failure; conducted in a treatment center or home. | Clinic, home | Secondary prevention | Adults | 42,700-70,000 per YLS (USA); 61,000-99,400 per QALY (USA) | 1 |
| Kidney disease | Kidney transplant | Kidney transplant surgery. | District or referral hospital | Cure | Adults | 10,000 per LYS (USA); 11,000 per QALY (USA) | 2 |
| Kidney disease | ACE inhibitors | ACE inhibitors for all type-1 diabetetics with macroproteinuria and all type-2 diabetics | Clinic | Secondary prevention | Adults | 1100-7700 per QALY (USA) | 4 |
| Mild to moderate asthma | Quick-releavers in addition to inhaled corticosteriods | Rapid-acting bronchodilators that act to relieve bronchoconstriction and accompanying acute symptoms of wheeze, chest tightness, and cough, e.g., salbutamol; incremental to inhaled corticosteroid treatment | Clinic or district hospital | Palliation | Adults | 10,600-13,900 per QALY (High-income countries) | 1 |
| Opioid abuse | Naltrexone induced rapid opioid detoxification under sedation (RODS) | Patient is given naltrexone under general anesthetic. | District hospital | Rehabilitation | Adults | 2,498 per week of abstinence (Australia) | 1 |
| Opioid abuse | Conventional outpatient detoxification | Conventional outpatient detoxification is supervised withdrawal from a drug of dependence that attempts to minimize withdrawal symptoms. | Clinic | Rehabilitation | Adults | 12,764 per abstinent patient (Australia) | 1 |
| Opioid abuse | Drug-free treatments | Residential or outpatient drug-free treatments as well as self-help group attendance | Clinic | Rehabilitation | Adults | 7000-13,000a (USA) | 1 |
| Opioid abuse | Methadone maintenance substitution | Substitution of short-acting heroin with long-acting orally administered opioid Methodone; includes heroin users living in communities with high HIV prevalence | Clinic | Rehabilitation | Adults | 6800 per LYS (High-income countries); 9000 per QALY (High-income countries, high-HIV prevalence) | 1 |
| Opioid abuse | Buprenorphine maintenance substitution | Buprenorphine substitution maintenance treatment for non-methadone patients. | Clinic | Rehabilitation | Adults | 49,000 per QALY (High-income countries) | 1 |
| Osteoarthritis | Lifestyle change | Exercise (aquatic) and calcium supplements | Clinic | Primary/secondary prevention | Adults age 55-75; post-menopausal women | 96,119-498,700 per QALY (High-income countries) | 1 |
| Osteoarthritis | Replacement surgery | Synovial fluid replacement (hylan G-F 20) for patients with osteoarthritis of the knee; or complete hip joint or knee replacement with implant | Clinic, district hospital | Secondary prevention; tertiary intervention | Elderly men and women | 5233-6893 per QALY (High income countries) | 1 |
| Osteoporosis | Hormone replacement therapy | Estrogen replacement from age 50, 60, or menopause for healthy women; 5-year to lifetime treatment | Clinic | Primary/secondary prevention | Postmenopausal women and women age 50 and up | 5088-23,734 per QALY | 1 |
| Osteoporosis | Calcium supplements with or without vitamin D | Calcium with or withouth vitamin D supplements, based on evidence that it reduces appendicular fractures; assumes a compliance rate of 70% | Clinic | Primary prevention | Women age 50 to 80 | 37,633-149,705 per QALY | 1 |
| Osteoporosis | Nonestrogen drug treatments | Raloxifene or calcitonin to reduce bone fractures; with or without 5 years of therapy | Clinic | Secondary prevention | Postmenopausal women age 50 to 80 | 34,166-835,622 per QALY (High income Countries) | 1 |
| Osteoporosis | Fluoride | Fluoride appears to decrease the risk of vertebral fracture for women with established osteoporosis; assumes neutral effect on hip fractures | Clinic | Secondary prevention | Postmenopausal women | 46,684 per QALY (UK) | 1 |
| Pain | Morphine | Providing oral morphine and necessary associated drugs | Clinic | Palliation | All ages | 210-408 per year of pain free life added (Chile, Romania, Uganda) | 4 |
| Primary care ailments | Limited care | Includes treatment of infection and minor trauma; for more complicated condition, includes diagnosis, advice and pain relief, and treatment as resources permit | Clinic | Cure | All ages | 253-380 per DALY (Low income countries); 507-760 per DALY (Middle income countries) | 1 |
| Respiratory disease (end stage) | Lung transplant | Surgical replacement with donor lung | District hospital | Cure | Adults | 238,200-464,000 per QALY (High-income countries) | 1 |
