Resources Repository
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ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Costing Methods | Global | Infectious Diseases | Evidence Synthesis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Global | Infectious Diseases | Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Decision Analysis | Global | Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis -
ArticlePublication 2019Cost-Effectiveness of Latent TB Screening before Immigration to Low-Incidence Countries
Despite prospective migrants to countries where the incidence of TB is low receiving TB screening …
Despite prospective migrants to countries where the incidence of TB is low receiving TB screening for active infections, screening for latent TB infection before immigration is rare. The authors used discrete event simulation to evaluate the cost-effectiveness preimmigration latent TB infection screening for migrants to low-incidence countries. They calculated cost per quality-adjusted life-year gained for migrants from countries with different TB incidences. Their analysis when combined with research on sustainability, acceptability, and program implementation can…
Dynamic Simulation | Global | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Government/Law | Health/Medicine -
ReviewPublication 2018Equity Considerations in CEA: Rotavirus Vaccine in LMIC's
The authors used a systematic review of the literature to identify economic evaluations of rotavirus …
The authors used a systematic review of the literature to identify economic evaluations of rotavirus vaccine in LMICs and assess the extent to which equity was considered in the objectives, analysis, and results. They used equity-related indicators provided in the Guidance on Priority Setting in Health Care (GPS-Health) checklist criteria resulting in 18 unique indicators tracked. The authors found that some articles incorporated the indicators in their model inputs (20%) while the majority (80%) presented…
Global | Social Determinants | Infectious Diseases | Evidence Synthesis | Cost-Effectiveness Analysis | Health/Medicine -
ArticlePublication 2017Costing of National STI Program Implementation, 2016-2021
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) …
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. This analysis costed scaling-up priority interventions to achieve coverage targets. Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service…
Costing Methods | Global | Clinical Care | Infectious Diseases | Evidence Synthesis | Economics/Finance | Health/Medicine -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Decision Analysis | Global | Infectious Diseases | Dynamic Transmission | Risk Analysis | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Costing Methods | Global | Infectious Diseases | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Costing Methods | Global | Infectious Diseases | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine