Browsing by Author "Kay, Chane"
Now showing 1 - 1 of 1
Results Per Page
Sort Options
- ItemThe cost effectiveness of treating paediatric cancer in South Africa: a review of treatment cost for Burkitt Lymphoma(Stellenbosch : Stellenbosch University, 2016-12) Kay, Chane; Van Zyl, Anel; Stefan, Cristina; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.ENGLISH SUMMARY: Background In middle and low income countries, childhood cancer is rare when compared to trauma and infectious diseases. There is a paucity of literature regarding the cost and cost-effectiveness of treatment for paediatric cancers to guide decisions on resource allocation. Burkitt Lymphoma (BL) is a fairly common paediatric cancer in South-Africa. Optimal treatment and supportive care of BL translates in high cure rates. Study aim To determine the cost to avert 1 Disability Adjusted Life Year (DALY) in treating children with Burkitt Lymphoma in Tygerberg Children’s Hospital and whether this meets the WHO-CHOICE threshold of cost-effectiveness. Methodology The study is a retrospective, longitudinal descriptive audit and cost-effectiveness analysis. Data was collected from all available records at Tygerberg Children’s Hospital and total direct cost for treatment and follow up was calculated. Using the WHO’s ‘Choosing Interventions that are Cost-Effective’ guidelines, the disability adjusted years of life lost averted by treatment were calculated and divided by the total cost of treatment. The result was compared to the South-African Gross Domestic Product (GDP) per capita. Results Ten patients treated for Burkitt Lymphoma between 2005 and 2010 were included in the study. The average direct cost was US$12829 per patient. A trend was found for treatment of late stage disease to be more expensive than early stage disease, as well as a less favourable prognosis of late stage disease, as expected. A trend was also noted for the treatment of HIV infected children with Burkitt Lymphoma to fall well within the very cost-effective threshold. Cost related to general supportive care, was by far the largest contributing factor with hospitalisation contributing 49% of the total cost. The average cost to avert 1 DALY, was US$610.52, thus the average ratio to GDP per capita was 0.1:1, which indicates that the treatment of BL in South-Africa is well within the limits of being very cost effective (1:1). Conclusion The treatment of children with Burkitt Lymphoma in Tygerberg Children’s Hospital, South Africa is very cost effective, as it is well below the WHO-CHOICE threshold of very cost-effectiveness. It is also very cost-effective to treat children with Burkitt Lymphoma who present with advanced disease as well as children with associated HIV infection. Cost constraints should therefore not be a limitation to treating children with Burkitt Lymphoma, even if they present with advanced stage disease or HIV infection. Similar cost-effective studies in another type of paediatric cancer, private health sector or low-income countries, should be done to verify that the treatment of childhood cancers is very cost-effective.