title: Investment Success in Public Health: An Analysis of the Cost-Effectiveness and Cost-Benefit of the Global Programme to Eliminate Lymphatic Filariasis.
abstract: It has been estimated that $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 program's current value. Here, we evaluate the cost-effectiveness and cost-benefit of the preventive chemotherapy that was provided under the GPELF between 2000 and 2014. In addition, we also investigate the potential cost-effectiveness of hydrocele surgery.
  
  
  
  Our economic evaluation of preventive chemotherapy was based on previously published health and economic impact estimates (between 2000 and 2014). The delivery costs of treatment were estimated using a model developed by the World Health Organization. We also developed a model to investigate the number of disability-adjusted life years (DALYs) averted by a hydrocelectomy and identified the cost threshold under which it would be considered cost-effective.
  
  
  
  The projected cost-effectiveness and cost-benefit of preventive chemotherapy were very promising, and this was robust over a wide range of costs and assumptions. When the economic value of the donated drugs was not included, 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 $66 and cost-effective if less than $398 (based on the World Bank's cost-effectiveness thresholds for low income countries).
  
  
  
  Both the preventive chemotherapy and hydrocele surgeries provided under the GPELF are incredibly cost-effective and offer a very good investment in public health.
authors.affiliation: London Centre for Neglected Tropical Disease Research, London, UK.|Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, UK.|Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.|Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom.
authors.forename: Hugo C
authors.initials: HC
authors.lastname: Turner
authors.affiliation: London Centre for Neglected Tropical Disease Research, London, UK.|Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, UK.
authors.forename: Alison A
authors.initials: AA
authors.lastname: Bettis
authors.affiliation: Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Atlanta, GA, USA.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Chu
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: McFarland
authors.affiliation: Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Atlanta, GA, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Hooper
authors.affiliation: Urology Unit, 37 Military Hospital, Korle-Bu, Accra, Ghana.
authors.forename: Sunny D
authors.initials: SD
authors.lastname: Mante
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fitzpatrick
authors.affiliation: Global Health Programs, GlaxoSmithKline, London, UK.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Bradley
mesh_terms: D000871:Anthelmintics / Q000627:therapeutic use; D018890:Chemoprevention / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D004605:Elephantiasis, Filarial / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D014943:Global Health / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs; D006801:Humans; D007449:Investments; D017063:Outcome Assessment, Health Care; D011634:Public Health / Q000191:economics* / Q000706:statistics & numerical data*
chemical_list: D000871:Anthelmintics
keywords: cost-benefit; economic evaluation; hydrocelectomy.; lymphatic filariasis; preventive chemotherapy