Investment success in public health: An analysis of the cost-effectiveness and cost-benefit of the Global Programme to Eliminate Lymphatic Filariasis.

BACKGROUND: It has been estimated that US$154 million per year will be required during 2015-2020 to continue the Global Programme to Eliminate Lymphatic Filariasis (GPELF). In light of this, it is important to understand the current value of the programme. In the paper, we evaluate the cost-effectiveness and cost-benefit of the preventive chemotherapy provided under the GPELF between 2000-2014. In addition, we also investigate the potential cost-effectiveness of hydrocele surgery.

METHODS: Our economic evaluation of preventive chemotherapy was based on previously published health and economic impact estimates (between the years 2000-2014). The delivery costs of treatment were estimated using a model developed by the WHO. We also developed a model to investigate the number of DALYs averted by a hydrocelectomy, and identified the cost threshold under which it would be considered cost-effective (US$246 per DALY averted).

RESULTS: The projected cost-effectiveness and cost-benefit of preventive chemotherapy were very promising and this was robust over a very wide range of costs and assumptions. When not including the economic value of the donated drugs, the GPELF would be classed as highly cost-effective. We projected that a typical hydrocelectomy would be classed as highly cost-effective if the surgery cost less than US$66, and cost-effective if less than US$398 (based on the World Bank cost-effectiveness thresholds).

CONCLUSIONS: Both the preventive chemotherapy and hydrocele surgeries provided under the GPELF are incredibly cost-effective and offer a very good investment in public health.