Evidence map›Paper›PMID 39871292›Full record

ArticleCost effectiveness and resource allocation : C/E2025

Cost-effectiveness and budget impact of covering Burkitt lymphoma in children under Ghana's National Health Insurance Scheme.

Richmond Owusu, Dakota Pritchard, Lieke Fleur Heupink, Godwin Gulbi, Brian Asare, Ivy Amankwah, Joycelyn Azeez, Martha Gyansa-Lutterodt, Lydia Dsane-Selby, Ruby Aileen Mensah and 6 more

Abstract read
In one paragraph

Article in Cost effectiveness and resource allocation : C/E, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

16 authors.

Richmond OwusuUniversity of Ghana School of Public Health, Accra, Ghana. riowusu@ug.edu.gh.
Dakota PritchardNorwegian Institute of Public Health, Oslo, Norway.
Lieke Fleur HeupinkNorwegian Institute of Public Health, Oslo, Norway.
Godwin GulbiMinistry of Health, Accra, Ghana.
Brian AsareMinistry of Health, Accra, Ghana.
Ivy AmankwahMinistry of Health, Accra, Ghana.
Joycelyn AzeezMinistry of Health, Accra, Ghana.
Martha Gyansa-LutterodtMinistry of Health, Accra, Ghana.
Lydia Dsane-SelbyNational Health Insurance Authority, Accra, Ghana.
Ruby Aileen MensahNational Health Insurance Authority, Accra, Ghana.
William Omane-AdjekumNational Health Insurance Authority, Accra, Ghana.
Francis RuizLondon School of Hygiene & Tropical Medicine, London, UK.
Mohamed GadLondon School of Hygiene & Tropical Medicine, London, UK.
Justice NonvignonUniversity of Ghana School of Public Health, Accra, Ghana.
Lumbwe CholaNorwegian Institute of Public Health, Oslo, Norway.
Ghana Health Technology Assessment Technical Working Group

Funding

International Decision Support Initiative (IDSi) OPP1202541Norwegian Agency for Development and Cooperation (NORAD) QZA-18/0102
6 · The paper itself

Abstract

backgroundChildhood cancer is not a high priority in health care financing for many countries, including in Ghana. Delayed care seeking and treatment abandonment, often due to the financial burden of care seeking to families, are common reasons for a relatively low overall survival (OS) in low-and middle-income countries. In this study, we analyzed the cost-effectiveness of extending health insurance coverage to children with Burkitt lymphoma (BL) in Ghana.

methodsWe developed a Markov model in Microsoft Excel to estimate the costs and effects of BL treatment when National Health Insurance Scheme (NHIS) was provided compared to the status quo where NHIS does not cover care for childhood cancer. The analysis was undertaken from the societal and health system (payer) perspective. Both costs (measured in $) and effects, measured using disability adjusted life years (DALYs), were discounted at a rate of 3%. The time horizon was a lifetime. Probabilistic sensitivity analysis was done to assess uncertainty in the measurement of the incremental cost-effectiveness ratio (ICER). A budget impact analysis was undertaken from the perspective of the NHIS.

resultsIn the base-case analysis, the intervention (NHIS reimbursed treatment) was less costly than current practice ($8,302 vs $9,558). The intervention was also more effective with less DALYs per patient than the standard of care (17.6 vs 23.33). The ICER was -$219 per DALY averted from societal perspective and $113 per DALY averted from health system perspective. The probabilistic sensitivity analysis showed that the intervention is likely to be both less costly and more effective than current practice in 100% of the 1,000 simulations undertaken.

conclusionProviding health insurance coverage to children with BL is potentially cost-effective. The effectiveness and cost-savings relating to this strategy is driven by its positive impact on treatment initiation and retention. Based on this evidence, there has been a policy change where Ghana's NHIS has prioritized financing for cancer treatment in children.

Identifiers

PMID39871292
PMCPMC11773855

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.