Resources Repository
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ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
Costing Methods | Health Systems | Infectious Diseases | State-Transition | Clinical Care | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Revealed Willingness-to-Pay vs. Standard Cost-Effectiveness Thresholds
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The …
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The use of CETs based on a country’s income per capita has been criticized for not being grounded in theory or evidence, especially in low and middle-income countries (LMICs). An alternative has been produced for South Africa, based on estimates of life years saved and the country’s committed HIV budget. The authors used a previously -published optimization method to estimate CETs,…
Infectious Diseases | Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Costs of Facility-Based HIV Testing in Malawi, Zambia and Zimbabwe
Providing HIV testing at health facilities remains the most common approach to ensuring access to …
Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. The authors sought to explore the costs of providing these services across three southern African countries with high HIV burden.Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for…
Costing Methods | Health Systems | Infectious Diseases | Technology Assessment | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Cost Determinants of Routine Infant Immunization Services
The EPIC study collected data on routine infant immunization costs from Benin, Ghana, Honduras, Moldova, …
The EPIC study collected data on routine infant immunization costs from Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. The authors estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. For each country, the economic costs of infant immunization were estimated by administrative level, budget category, and programmatic activity from a program perspective. Regression models were…
Costing Methods | Health Systems | Infectious Diseases | Child/Nutrition | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean -
ArticlePublication 2017Estimated Economic Impact of Vaccinations in 73 LMIC, 2001-2020
This analysis estimates the economic impact likely to be achieved by efforts to vaccinate against 10 …
This analysis estimates the economic impact likely to be achieved by efforts to vaccinate against 10 vaccine-preventable diseases between 2001 and 2020 in 73 low- and middle-income countries largely supported by Gavi, the Vaccine Alliance. The authors used health impact models to estimate the economic impact of achieving forecasted coverages for vaccination against Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae and yellow fever. In…
Dynamic Transmission | Health Systems | Infectious Diseases | Health Outcomes | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Child/Nutrition | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Health Systems | Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Health Systems | Infectious Diseases | Priority Setting/Ethics | Mathematical Models | Cost-Effectiveness Analysis | Operations Research | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Household Expenditures on Pneumonia and Diarrhoea Treatment
This article, published in BMJ Global Health, quantifies household out-of-pocket (OOP) expenditure for treatment of …
This article, published in BMJ Global Health, quantifies household out-of-pocket (OOP) expenditure for treatment of childhood pneumonia and diarrhoea and estimates its impact on poverty for different socioeconomic groups in Ethiopia. The study finds that wealthier and urban households have higher OOP payments, but poorer and rural households are more likely to be impoverished due to medical payments. The present circumstances call for revisiting the existing health financing strategy for high-priority services that place a…
Costing Methods | Health Systems | Infectious Diseases | Child/Nutrition | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Funding Gap for Immunization Across 94 Low- and Middle-Income Countries
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 …
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 low- and middle-income countries over the five-year period of 2016–2020. Vaccine financing by country governments, GAVI, and other development sources was forecasted for vaccine, supply chain, and service delivery based on an analysis of comprehensive multi-year plans together with a series of scenarios. The authors found that that delivery of full vaccination programs across the 94 countries would result in a total…
Costing Methods | Health Systems | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Global Governance | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific