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…
Evidence Synthesis | Costing Methods | Health/Medicine | Economics/Finance | Global | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems -
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…
Evidence Synthesis | Costing Methods | Health/Medicine | Economics/Finance | Global | Infectious Diseases | Clinical Care -
ArticlePublication 2015Achieving a 'Grand Convergence' in Global Health
The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment …
The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment case for a grand convergence in health outcomes globally. In support of the drafting of the Sustainable Development Goals (SDGs), this paper presents estimates of what the grand convergence investment case might achieve—and what investment would be required—by 2030. The authors start with a country-based (bottom-up) analysis of the costs and impact of…!--?xml:namespace prefix = "o" ns = "urn:schemas-microsoft-com:office:office" /-->
Costing Methods | Health Outcomes | Health/Medicine | Economics/Finance | Global | Global Governance | Cost-Effectiveness Analysis | Health Systems | Science/Technology -
ArticlePublication 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Test Performance | Health/Medicine | Economics/Finance | Global | Infectious Diseases | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | North America -
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 | Health/Medicine | Economics/Finance | Global | Infectious Diseases | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Government/Law | 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 | Health/Medicine | Economics/Finance | Global | Infectious Diseases | Cost-Effectiveness Analysis | Health Systems -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Health Outcomes | Health/Medicine | Global | Infectious Diseases | Maternal/Reproductive Health | Policy/Regulation -
ArticlePublication 2020Interpreting COVID-19 Test Results: A Bayesian Approach
This article considers the following question with respect to interpreting the results of polymerase chain reaction …
This article considers the following question with respect to interpreting the results of polymerase chain reaction (PCR) assays from nasal and pharyngeal swabs for COVID-19 to inform clinical decision making: "While a positive result in an acutely ill patient is straightforward, how should physicians interpret negative tests in patients with suspected COVID-19 infection?" Using an assumption of near-perfect specificity of PCR assays for COVID-19, the authors acknowledge the uncertainty of test sensitivity. They consider two clinical scenarios…
Test Performance | Health/Medicine | Global | Infectious Diseases | Probability/Bayes | Science/Technology -
ArticlePublication 2019Systematic Review of Economic Evaluations of Vaccination Strategies Against Tuberculosis
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited …
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited and varies by age, so a valid cost-effectiveness study is needed to assist decision-makers in the implementation of cost-effective strategies for BCG vaccination. Using the Quality of Health Economic Studies (QHES) instrument, the authors assessed the quality of published studies involving economic evaluations of BCG vaccination strategies in a variety of regions, target populations, and vaccine types. Most of the…
Evidence Synthesis | Health/Medicine | Global | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis