Table 1 Disease burden rank, pharmacoeconomic evidences and their 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)