Resources Repository
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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…
Microsimulation | North America | Global | Infectious Diseases | Test Performance | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
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…
Microsimulation | Global | Infectious Diseases | Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa -
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,…
Microsimulation | Global | Infectious Diseases | Mathematical Models | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis -
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…
Microsimulation | North America | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Latin America & Caribbean -
ArticlePublication 2021Rational Policymaking during a Pandemic
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and …
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and its global impacts are unprecedented, decisions are taken in a highly uncertain, complex, and rapidly changing environment. In such a context, in which human lives and the economy are at stake, the authors argue that using ideas and constructs from modern decision theory, even informally, will make policymaking a more responsible and transparent process.
Decision Theory | Priority Setting/Ethics | Global | Infectious Diseases | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2018Should We Treat Acute Hepatitis C? A Decision and Cost-Effectiveness Analysis
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared …
This study examines the potential benefits of treating acute hepatitis C virus (HCV) infection compared to deferring treatment until the chronic phase, utilizing a microsimulation model. By projecting long-term outcomes such as quality-adjusted life years (QALYs) and costs, the analysis evaluates the cost-effectiveness of initiating therapy during the acute phase. Results indicate that treating acute HCV increases QALYs by 0.02 and costs by $483 per patient not at risk of transmitting HCV, yielding an incremental…
Microsimulation | North America | Infectious Diseases | Decision Analysis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2016Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons
This study assesses the health and economic impact of hepatitis C virus (HCV) screening and …
This study assesses the health and economic impact of hepatitis C virus (HCV) screening and treatment in U.S. prisons on the broader HCV epidemic. Employing an agent-based microsimulation model of HCV transmission and disease progression, data from published literature inform the analysis. The target populations include individuals in U.S. prisons and the general community over a 30-year timeframe, adopting a societal perspective. Interventions encompass risk-based and universal opt-out HCV screening in prisons, followed by treatment…
Microsimulation | North America | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine -
ReviewPublication 2016Decision Support for Infectious Disease Control
This report from RAND reviews decision-support tools, including models and nonmodeling approaches, that are relevant to …
This report from RAND reviews decision-support tools, including models and nonmodeling approaches, that are relevant to infectious disease prevention, detection, and response and aligns these tools with real-world policy questions that the tools can help address. This overview is designed to help modelers and other technical experts understand the questions that policymakers will raise and the decisions they must make. The report also presents policymakers with the capabilities and limitations of the different tools that may…
Microsimulation | Global | Infectious Diseases | Mathematical Models | State-Transition | Dynamic Transmission | Dynamic Simulation | Global Governance | Government/Law | Health/Medicine | Military/Defense -
ArticlePublication 2015Cost-Effectiveness & Budget Impact of Hepatitis C Virus Treatment with Sofosbuvir & Ledipasvir in the U.S.
This study evaluates the cost-effectiveness and budget impact of sofosbuvir and ledipasvir for treating chronic …
This study evaluates the cost-effectiveness and budget impact of sofosbuvir and ledipasvir for treating chronic hepatitis C virus (HCV) infection compared to the old standard of care (oSOC). Using a microsimulation model based on HCV natural history, data from published literature, and a third-party payer perspective, the analysis considers treatment-naive and treatment-experienced HCV populations in the United States over a lifetime horizon. Sofosbuvir-based therapies are found to add 0.56 quality-adjusted life-years (QALYs) relative to oSOC,…
Microsimulation | North America | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine