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Disability Adjusted Life Year (DALY) improvement at high cost
Table 4a Health Interventions with Limited Effectiveness
|
Intervention From: Health Sector Reform in Asia and the Pacific – options for developing countries – Asia Development Bank 1999 |
Prioritization factors |
|||||
|
Cost/ DALY ($) |
Evidence of medical efficacy |
Burden Corrects |
Improves equity |
|||
|
Vector control for dengue using drainage and land management |
>$1,000 |
1 = Difficult to show benefit |
Low to moderate |
Yes |
Yes |
|
|
Fetal ultrasound |
Unknown but likely high |
3 = Limited prospective data show no impact on outcome |
Not applicable |
No |
No |
|
|
X-rays for low back pain
|
Unknown but likely high |
4 = Good clinical data show ineffective unless other risk factors present |
Low |
|
No |
No |
|
Evaluation for heart attack |
>41,000 |
4 = Clinical data show surgery effective in subset of patients |
Low |
|
No |
No |
|
Surgery for cancer |
> $1,000 |
3 = Data show clinical staging critical; outcomes varied |
Low |
|
No |
No |
|
Surgery for coronary artery disease |
>$ 1,000 |
4 = Effective in few patients |
Low to moderate |
No |
No |
|
|
Surgery for leprosy complication |
$75-250 |
2 = Appears effective |
Low |
|
No |
No |
|
Medical treatment of tetanus |
$75-250 |
3 = Clinical supportive care can be effective |
Low |
|
No |
No |
|
Antibiotic prevention for children |
$75-250 |
1 = Effectiveness difficult to assess |
Low |
|
No |
No |
Notes: Evidence:
4 = Good prospective, randomized studies with convincing results
3 = Some prospective, well-designed studies
2 = Cohort cross-sectional data
1 = Case study or common practice only
Source: Adapted from Jamison etal. (1993). Disease Control Priorities in
Developing Countries