Resources Repository
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ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Cost-Effectiveness Analysis | Infectious Diseases | Microsimulation | Health/Medicine | Global | Sub-Saharan Africa -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
State-Transition | Infectious Diseases | Value of Information | Benefit-Cost Analysis | Policy/Regulation | Economics/Finance | North America | Europe -
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,…
Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Global -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | Microsimulation | North America | Latin America & Caribbean -
ArticlePublication 2022Healthcare Cost of Overweight & Obesity in South Africa
This analysis estimates the healthcare cost associated with treatment of weight-related conditions from the perspective …
This analysis estimates the healthcare cost associated with treatment of weight-related conditions from the perspective of the South African public sector payer. The authors report that the total cost of overweight and obesity is estimated to be ZAR33,194 million in 2020, representing approximately 15% of government health expenditure and equivalent to 0.67% of GDP. This analysis is an example of a bottom-up gross costing approach. The study draws South African data from multiple sources to estimate…
Cost-Effectiveness Analysis | Health Systems | Costing Methods | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Child Health Inequity through Case Management of Under-Five Malaria in Nigeria: An ECEA
This study assesses the potential impact of subsidies covering the direct and indirect costs of …
This study assesses the potential impact of subsidies covering the direct and indirect costs of under-five malaria case management in Nigeria, utilizing an extended cost-effectiveness analysis (ECEA) and a decision tree model. Findings reveal that fully subsidizing medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8,600 cases of catastrophic health expenditure (CHE), and US$187 million in out-of-pocket (OOP) spending. Per US$1 million invested, this translates to a significant reduction in under-five…
Cost-Effectiveness Analysis | Infectious Diseases | Health Outcomes | Mathematical Models | Child/Nutrition | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2021Health Opportunity Cost Threshold for CEA in the U.S.
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, …
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Health Outcomes | Evidence Synthesis | Microsimulation | Policy/Regulation | Health/Medicine | North America -
ArticlePublication 2020Burden of Household OOP Health Expenditures
This article, published in Health Policy and Planning, estimates the incidence of catastrophic and impoverishing …
This article, published in Health Policy and Planning, estimates the incidence of catastrophic and impoverishing health expenditures using data from the 2015/16 Ethiopian household consumption and expenditure and welfare monitoring surveys. The authors compute the incidence of catastrophic health expenditures (CHE) at 10% and 25% thresholds of total household consumption and 40% threshold of household capacity to pay. Impoverishing health expenditures (IHE) are calculated using Ethiopia's national poverty line (ETB 7184 per adult per year).…
Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2019Long-Term Cost-Effectiveness of Obesity Prevention Interventions in the Early Years of Life
This analysis estimated the long-term health benefits and health care cost-savings of reductions in body …
This analysis estimated the long-term health benefits and health care cost-savings of reductions in body mass index (BMI) for the Australian population of children aged between 2 and 5 years. A proportional multistate, multiple cohort, lifetable model estimated the health benefits and health care cost-savings related to hypothetical reductions in BMI, informed by a scoping review of systematic reviews reporting the effectiveness of obesity prevention interventions in preschool aged children. Results suggested significant potential for…
Cost-Effectiveness Analysis | Health Systems | Child/Nutrition | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Oceania