Appendix [ — 📋 High-Impact Health Interventions

Introduction

This article compares the dFDA Infrastructure to other historically high-ROI and high-QALY-per-dollar health interventions. The table below summarizes the best available data for each intervention, including return on investment (ROI), cost per QALY gained (ICER), and estimated QALYs gained per $1 million spent. This provides context for the scale and efficiency of dFDA relative to foundational public health measures.

QALY Comparison Chart

Note: The bar represents the mid-point of the uncertainty range, and the error bars indicate the lower and upper bounds of the estimate. For “Smallpox Eradication,” the upper bound is illustrative of its high, open-ended impact.

Comparison Table

Intervention	Estimated ROI (Return per $1)	Cost per QALY Gained (ICER)	QALYs Gained per $1M	Notes & Sources
dFDA Infrastructure	66:1 to 2,577:1 (central: 463:1)	Dominant (cost-saving)	5,000–90,000+	Systemic, global, leverages all R&D; see dFDA Cost-Benefit Analysis
Smallpox Eradication	159:1 to 400:1	Dominant (cost-saving)	10,000+	Smallpox eradication ROI
Childhood Vaccination (US)	10:1 to 16:1	Dominant (cost-saving)	1,000–10,000	Childhood vaccination
Clean Water & Sanitation (LMICs)	4:1 to 21:1	Dominant/very cost-effective	1,000–10,000	Clean water & sanitation
Tobacco Control (taxes, bans)	20:1 to 1,057:1	Dominant/very cost-effective	1,000–10,000	Tobacco control
Hypertension Screening & Treatment	Varies / Cost-Saving	$500–$1,600	200–2,000	Hypertension screening
Statins for High-Risk Patients	Varies / Cost-Saving	£280–£8,530	50–200	Statins
Polypill for Primary Prevention (High-Risk)	Varies / Cost-Saving	up to £18,811 per QALY	50-200	Polypill
Generic Drug Substitution	Highly Cost-Saving	Dominant (cost-saving)	100–1,000	Generic drugs

Key:

• ROI: Return on investment; dollars saved or value created per $1 spent.
• Cost per QALY Gained (ICER): Lower is better; “Dominant” means saves money and improves health. Values may be in USD ($) or GBP (£).
• QALYs Gained per $1M: Rough estimate, varies by context and population.

Conclusion

The dFDA Infrastructure is projected to have a higher ROI and more QALYs per dollar than almost any other single health intervention, rivaled only by foundational public health measures like smallpox eradication and mass vaccination in low-resource settings. Most other interventions, while highly cost-effective, do not approach the systemic leverage or scale of dFDA.