ClinicoEconomics and Outcomes Research (Jun 2023)
Cost and Cost-Effectiveness of Treating Childhood Cancer at Jimma Medical Center
Abstract
Idiris Genemo,1 Temesgen Kabeta Chala,1 Diriba Fufa Hordofa,2 Shimeles Ololo Sinkie1 1Department of Health Policy and Management, Jimma University, Jimma, Oromia, Ethiopia; 2Department of Pediatric Oncology Unit, Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Idiris Genemo, P.O.B. 378, Jimma, Ethiopia, Tel +251911052719, Fax +214-047-111-44-84, Email [email protected]: More than 70% of childhood cancer patients die in Sub-Saharan African countries due to a lack of access. Additionally establishing a childhood cancer treatment service is perceived as expensive by the decision-makers of LMICs. However, there is a paucity of evidence on the actual cost and cost-effectiveness of this service in LMICs including Ethiopia. This study provides context-relevant evidence to consider childhood cancer treatment in the healthcare priority settings in Ethiopia and other LMICs.Methods: Newly admitted case files of children for the year 2020/21 were reviewed. The cost was analyzed from the provider’s perspective. The effectiveness was calculated using DALY averted based on the 5 years of survival rates, which is estimated from the 1-year survival rate of Kaplan–Meier output. The do-nothing was our comparator, and we assumed no cost (zero cost) will be incurred for the comparator. To account for sensitivity analyses, we varied the discount rate, 5-year survival rate, and life expectancy.Results: During the study period, 101 children were treated in the unit. The total annual and unit cost to give treatment to childhood cancer patients was estimated at $279,648 and $2769, respectively. The highest per-patient annual unit cost of treatment was Hodgkin’s lymphoma ($6252), while Retinoblastoma ($1520) was the least. The cost per DALY averted was $193, which is significantly less than Ethiopia’s GDP per capita ($936.3). The results remained very cost-effective in sensitivity analyses.Conclusion: Childhood cancer treatment is very cost-effective in Ethiopia as per WHO-CHOICE thresholds even in a conservative adjustment of assumptions. Therefore, to enhance and improve children’s health, childhood cancer should get a better concern in health priority.Keywords: unit cost, cost-effectiveness, childhood cancer, Ethiopia
