Resources Repository
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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…
Cost-Effectiveness Analysis | Infectious Diseases | Priority Setting/Ethics | Benefit-Cost Analysis | Policy/Regulation | Economics/Finance | Health/Medicine | Global | North America -
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 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Microsimulation | Clinical Care | 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,…
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 -
ReviewPublication 2022Systematic Review of Economic Evaluations of COVID-19 Interventions: Non-Health Impacts and Distributional Issues
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether …
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether they incorporated non-health impacts and distributional concerns. Among the 70 articles included, more than half (56%) included at least one non-health impact, although only 21% incorporated non-economic consequences. Only 17% examined subgroups of interest. The median ICER for the entire sample was $67,000/quality-adjusted life-year (QALY) (interquartile range [IQR] $9000-$893,000/QALY). Interventions including a pharmaceutical component yielded a median ICER of $93,000/QALY (IQR…
Cost-Effectiveness Analysis | Infectious Diseases | Evidence Synthesis | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2022Health Utility of Drinkers' Family Members
Problematic alcohol use is known to harm individuals surrounding the drinker. This study described the …
Problematic alcohol use is known to harm individuals surrounding the drinker. This study described the health utility of people who reported having a family member(s) whom they perceived as a “problem drinker.” Using a US population dataset, and adjusting for other drinking-related factors, perceiving a family member as a problem drinker was associated with lower health utility on the order of 0.033 (P < 0.001) for a spouse/partner to 0.023 (P < 0.001) for a…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Preferences/Values | North America -
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 | Chronic Disease/Risk | Costing Methods | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Duration & Cost-Effectiveness of Hepatocellular Carcinoma Surveillance in Hepatitis C Patients After Viral Eradication
This study assesses the cost-effectiveness of biannual surveillance for hepatocellular carcinoma (HCC) in patients cured …
This study assesses the cost-effectiveness of biannual surveillance for hepatocellular carcinoma (HCC) in patients cured of hepatitis C virus (HCV) using oral direct-acting antivirals (DAAs). A microsimulation model of HCC natural history in individuals with HCV-related advanced fibrosis or cirrhosis post-DAAs was developed, integrating data on HCC incidence, tumor progression, surveillance adherence, and health state costs/utilities. Biannual ultrasound and alpha-fetoprotein surveillance were compared to no surveillance over varying durations (5 years to lifetime). Results indicate…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Microsimulation | Health/Medicine | North America