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. 2015 Jul;143(9):1791-802.
doi: 10.1017/S0950268814001940. Epub 2014 Dec 12.

Use of DALYs in economic analyses on interventions for infectious diseases: a systematic review

A J J M Oostvogels  1 , G A De Wit  1 , B Jahn  2 , A Cassini  3 , E Colzani  3 , C De Waure  4 , M E E Kretzschmar  1 , U Siebert  2 , N Mühlberger  2 , M-J J Mangen  1
Affiliations

Use of DALYs in economic analyses on interventions for infectious diseases: a systematic review

A J J M Oostvogels et al. Epidemiol Infect. 2015 Jul.

Abstract

A systematic literature review was performed on full economic evaluations of infectious disease interventions using disability-adjusted life years (DALY) as outcome measure. The search was limited to the period between 1994 and September 2011 and conducted in Medline, SciSearch and EMBASE databases. We included 154 studies, mostly targeting HIV/AIDS and malaria with most conducted for African countries (40%) and <10% in high-income countries. Third-payer perspective was applied in 29% of the studies, 25% used the societal perspective and 12% used both. Only 16% of the studies took indirect effects (i.e. herd immunity) of interventions into account. Intervention, direct healthcare and indirect non-healthcare costs were taken into account in respectively 100%, 81% and 36% of the studies. The majority of the studies followed the Global Burden of Disease method for DALY estimations, but most studies deviated from WHO cost-effectiveness guidelines. Better adherence to freely accessible guidelines will improve generalizability between full economic evaluations.

Keywords: Cost-effectiveness analysis; costs; disability-adjusted life years (DALYs); economic evaluation; infectious diseases; systematic review.

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Conflict of interest statement

E.C. and A.C. are employed by the European Centre for Disease Prevention and Control (ECDC), the institution funding this research.

Figures

Fig. 1.
Fig. 1.
Study flowchart.
Fig. 2.
Fig. 2.
Annual number of published economic evaluations using DALYs as health outcome. * Number of papers in 2011 until 1 September.
See this image and copyright information in PMC

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