Use of DALYs in economic analyses on interventions for infectious diseases: a systematic review.
A J J M Oostvogels, G A De Wit, B Jahn, A Cassini, E Colzani, C De Waure, M E E Kretzschmar, U Siebert, N Mühlberger, M-J J Mangen
Author Information
A J J M Oostvogels: University Medical Centre Utrecht (UMCU),Utrecht,The Netherlands.
G A De Wit: University Medical Centre Utrecht (UMCU),Utrecht,The Netherlands.
B Jahn: Institute of Public Health, Medical Decision Making and Health Technology Assessment,Department of Public Health and Health Technology Assessment,UMIT - University for Health Sciences,Medical Informatics and Technology,Hall i.T.,Austria.
A Cassini: European Centre for Disease Prevention and Control (ECDC),Stockholm,Sweden.
E Colzani: European Centre for Disease Prevention and Control (ECDC),Stockholm,Sweden.
C De Waure: Institute of Public Health, Catholic University of the Sacred Heart,Rome,Italy.
M E E Kretzschmar: University Medical Centre Utrecht (UMCU),Utrecht,The Netherlands.
U Siebert: Institute of Public Health, Medical Decision Making and Health Technology Assessment,Department of Public Health and Health Technology Assessment,UMIT - University for Health Sciences,Medical Informatics and Technology,Hall i.T.,Austria.
N Mühlberger: Institute of Public Health, Medical Decision Making and Health Technology Assessment,Department of Public Health and Health Technology Assessment,UMIT - University for Health Sciences,Medical Informatics and Technology,Hall i.T.,Austria.
M-J J Mangen: University Medical Centre Utrecht (UMCU),Utrecht,The Netherlands.
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.
