Resources Repository
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ArticlePublication 2024Hepatitis C Elimination in Rwanda: Progress, Feasibility, Economic Evaluation
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis …
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis C virus (HCV) and identifies strategies to achieve World Health Organization (WHO) elimination goals by 2030. Employing a microsimulation model spanning 2015 to 2050, the analysis assesses HCV epidemic trends, prevalence, mortality, and total care costs under various scenarios. Results show that between 2018 and 2022, over 7 million people were screened and 60,000 treated, projecting Rwanda's potential achievement of…
Microsimulation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Modeling the Relative Risk of Incidence and Mortality of Select Vaccine-Preventable Diseases
Immunization is one of the most effective public health interventions, saving millions of lives every …
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. This paper models the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillomavirus, measles, and pneumonia) by wealth quintile and geographic region in Ethiopia. The authors approach…
Evidence Synthesis | Infectious Diseases | Priority Setting/Ethics | Social Determinants | Health/Medicine | Sub-Saharan Africa -
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 | Infectious Diseases | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Microsimulation | Infectious Diseases | Priority Setting/Ethics | Sub-Saharan Africa -
ArticlePublication 2022Vaccinations versus Lockdowns to Prevent COVID-19 Mortality
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly …
This analysis estimated the costs associated with preventing Covid-19 deaths by vaccinations versus lockdowns. Publicly available datasets from the Israeli Ministry of Health were used to model the parameters of the pandemic in Israel. The Oxford COVID-19 Government Response Tracker was used for quantitative data on government policies. Data on the Israeli economy were taken from the Central Bureau of Statistics. The models demonstrate that the first lockdown prevented 1022 COVID-19 deaths at the cost…
Decision Theory | Infectious Diseases | Costing Methods | Health Outcomes | State-Transition | Decision Analysis | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine | Middle East & North Africa -
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 | Infectious Diseases | Cost-Effectiveness Analysis | Health/Medicine | Global | 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 | Infectious Diseases | Mathematical Models | Calibration/Validation | Decision Analysis | Cost-Effectiveness 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…
Microsimulation | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | 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…
Evidence Synthesis | Infectious Diseases | Cost-Effectiveness Analysis | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America