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The cost effectiveness of treating Burkitt lymphoma in Uganda

Avram E Denburg1, Nazeefah Laher1,2, Innocent Mutyaba3,4

  • 1The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Cancer
|March 7, 2019
PubMed

Insights

Treating childhood Burkitt lymphoma (BL) in Uganda is highly cost-effective, averting disability-adjusted life-years (DALYs) at a low cost. This finding supports prioritizing childhood cancer treatment programs in low- and middle-income countries (LMICs).

Area of Science:

  • Global Health Economics
  • Pediatric Oncology
  • Health Policy Research

Background:

  • Childhood cancer treatment programs face political barriers in low- and middle-income countries (LMICs) due to perceived high costs.
  • Limited data exists on the actual cost and cost-effectiveness of these essential programs.
  • Burkitt lymphoma (BL) is the most common childhood cancer in Africa, necessitating effective treatment strategies.

Purpose of the Study:

  • To conduct an economic evaluation of a comprehensive BL treatment program in Uganda.
  • To determine the cost-effectiveness of BL therapy in a low-income country (LIC) setting.
  • To provide evidence for prioritizing childhood cancer treatment in LMICs.

Main Methods:

  • A comparative analysis of BL treatment versus usual care for 122 patients (2012-2014).
  • Inclusion of variable, fixed, and family costs in the economic evaluation.
  • Calculation of cost per disability-adjusted life-year (DALY) averted using WHO-CHOICE methodology.

Main Results:

  • The 2-year overall survival (OS) rate for treated patients was 55%.
  • The cost per DALY averted was US$97 (Int$301), well within WHO-CHOICE thresholds.
  • The intervention demonstrated a very cost-effective ratio of 0.14 to per capita GDP.

Conclusions:

  • Locally tailored protocols for treating BL in LMICs are highly cost-effective by international standards.
  • This study provides crucial evidence for policymakers regarding resource allocation for childhood cancers.
  • Economic evaluations are vital for prioritizing noncommunicable disease interventions, including pediatric cancers, in LMICs.
Abstract

Keywords:
childhood cancercost effectivenessglobal healthhealth policylymphoma

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