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Table 1 Disease burden rank, pharmacoeconomic evidences and their main findings, implications and current listing status

From: Pharmacoeconomics and its implication on priority-setting for essential medicines in Tanzania: a systematic review

Rank Disease Tanzanian pharmacoeconomic evidence Main findings, implications and current listing status
1 HIV/AIDS HAART for PMTCT[21] Highly cost-effective intervention with ICER of US$ 162 per DALY averted when compared to sd-NVP, however it is 40% more costly but 5 times more effective
  ( Listing status: HAART is one of the two options recommended by WHO but not the one being implemented in Tanzania, an area for future research)
Sd-NVP for PMTCT[24] ( Listing status: Use of Sd-NVP is the old policy which was also based on WHO’s recommendations but currently being phased out in Tanzania)
2 Malaria ALu for non-severe malaria[26] A cost-effective drug which saves US$ 22.4 per case averted when compared to amodiaquine. (Listing status: ALu is one of the few artemisinin-based combination therapies recommended by WHO and is the current drug of choice in Tanzania)
SP for non-severe malaria[25] ( Listing status: Use of SP was replaced by ALu since 2007 due to parasite resistance but still listed as essential medicine for IPTp)
SP for IPTi[27] A cost-effective intervention with ICER of US$ 1.6-12.2 per DALY* averted. SP-IPTi reduces episodes of clinical malaria and anaemia by 30 and 21 percent in areas of moderate to high malaria transmissions, in the first year of life[32].
  ( Listing status: SP-IPTi is a new intervention strategy recommended by WHO since 2010 but not yet adopted in Tanzania)
3 Diarrhoeal diseases Zinc as adjunct therapy[23] A highly cost-effective intervention when combined with ORS with ICER of US$ 73 per DALY averted
  ( Listing status: Listed on essential medicine list since 2007, based on WHO’s recommendations)
4 Injury/ Trauma Tranexamic acid Inj for surgical bleeding and trauma patients[20, 29] A highly cost-effective intervention with ICER of US$ 93 and US$ 48 per life saved for surgical and trauma patients*. TXA reduces number of transfusions by one-third and volume of blood per transfusion by one unit in elective surgery[33]. TXA reduces risks of death by 21% if administered within 3 hrs after injury[34].
( Listing status: Tranexamic acid Inj. was listed recently on WHO’s list of essential medicine but not yet listed in Tanzania)
5 ARI None None
6 TB Short-course chemotherapy[31] A highly cost-effective option with ICER of US$ 1–4 per LY saved. Short-course chemotherapy increases cure rate by 25% compared to the long regimens.
( Listing status: Listed; Introduced and adopted in Tanzania in mid 1980’s)
7 Prenatal conditions None None
8 Maternal deficiencies None None
9 Nutritional deficiencies Iron+ Deltaprim to prevent anaemia and malaria in infants[28] Considered to be a cost-effective intervention, support the evidence shown by SP-IPTi in reduction of both anaemia and malaria
( Listing status: Deltaprin (dapsone +pryrimethamine) is not listed as essential medicine in Tanzania
10 CVD and Diabetes Preventive cardiology[22] Diuretics, Aspirin+Diuretic and Aspirin+Diuretic+β-blocker are very cost-effective with ICERS of US$ 85, 143 and 317 per DALYS averted.
( Listing status : new evidence but these drugs were already listed as essential medicines before the publication of the study)
11 Neoplasms None None
12 Immunisable diseases Anti-Rabies vaccine[30] A very cost-effective intervention with ICER of US$ of 27 and 32 per DALY* averted from provider and societal perspectives.
    ( Listing status: New evidence, but the vaccine was already listed as essential medicine before the publication of the study)
  1. * Compared to do nothing, ALu-artemether-lumefantrine, SP- sulphadoxine-pyrimethamine, Sd-Single dose, HAART-Highly active antiretroviral drugs, ORS-Oral rehydration salt, ARI-acute respiratory tract infections, CVD-cardiovascular diseases.