{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T11:27:41Z","timestamp":1768822061697,"version":"3.49.0"},"reference-count":55,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016190","name":"Trond Mohn Foundation","doi-asserted-by":"crossref","award":["BFS2019TMT02"],"award-info":[{"award-number":["BFS2019TMT02"]}],"id":[{"id":"10.13039\/100016190","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007843","name":"Norwegian Agency for Development Cooperation","doi-asserted-by":"crossref","award":["RAF-18\/0009"],"award-info":[{"award-number":["RAF-18\/0009"]}],"id":[{"id":"10.13039\/100007843","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Bergen, Bergen Centre for Ethics and Priority Setting","award":["BCEPS 813 596"],"award-info":[{"award-number":["BCEPS 813 596"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,1]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the cost-effectiveness of running a paediatric oncology unit in Ethiopia to inform the revision of the Ethiopia Essential Health Service Package (EEHSP), which ranks the treatment of childhood cancers at a low and medium priority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We built a decision analytical model\u2014a decision tree\u2014to estimate the cost-effectiveness of running a paediatric oncology unit compared with a do-nothing scenario (no paediatric oncology care) from a healthcare provider perspective. We used the recently (2018\u20132019) conducted costing estimate for running the paediatric oncology unit at Tikur Anbessa Specialized Hospital (TASH) and employed a mixed costing approach (top-down and bottom-up). We used data on health outcomes from other studies in similar settings to estimate the disability-adjusted life years (DALYs) averted of running a paediatric oncology unit compared with a do-nothing scenario over a lifetime horizon. Both costs and effects were discounted (3%) to the present value. The primary outcome was incremental cost in US dollars (USDs) per DALY averted, and we used a willingness-to-pay (WTP) threshold of 50% of the Ethiopian gross domestic product per capita (USD 477 in 2019). Uncertainty was tested using one-way and probabilistic sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incremental cost and DALYs averted per child treated in the paediatric oncology unit at TASH were USD 876 and 2.4, respectively, compared with no paediatric oncology care. The incremental cost-effectiveness ratio of running a paediatric oncology unit was USD 361 per DALY averted, and it was cost-effective in 90% of 100\u2009000 Monte Carlo iterations at a USD 477 WTP threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The provision of paediatric cancer services using a specialised oncology unit is most likely cost-effective in Ethiopia, at least for easily treatable cancer types in centres with minimal to moderate capability. We recommend reassessing the priority-level decision of childhood cancer treatment in the current EEHSP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068210","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T10:27:42Z","timestamp":1678789662000},"page":"e068210","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Cost-effectiveness of running a paediatric oncology unit in Ethiopia"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2499","authenticated-orcid":false,"given":"Mizan","family":"Kiros","sequence":"first","affiliation":[{"name":"Bergen Centre for Ethics and Priority Setting (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3806-2453","authenticated-orcid":false,"given":"Solomon Tessema","family":"Memirie","sequence":"additional","affiliation":[{"name":"Bergen Centre for Ethics and Priority Setting (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"},{"name":"Addis Center for Ethics and Priority Setting, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-7807","authenticated-orcid":false,"given":"Mieraf Taddesse Taddesse","family":"Tolla","sequence":"additional","affiliation":[{"name":"Bergen Centre for Ethics and Priority Setting (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Tekle","family":"Palm","sequence":"additional","affiliation":[{"name":"Department of Health Financing, Clinton Health Access Initiative, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Hailu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Pediatric Hematology\/Oncology Unit, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-5956","authenticated-orcid":false,"given":"Ole F","family":"Norheim","sequence":"additional","affiliation":[{"name":"Bergen Centre for Ethics and Priority Setting (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"},{"name":"Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"2025121407520036000_13.3.e068210.1","doi-asserted-by":"publisher","DOI":"10.3945\/an.116.012211"},{"key":"2025121407520036000_13.3.e068210.2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2025121407520036000_13.3.e068210.3","unstructured":"International Agency for Research on Cancer . 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