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 | Cost-Effectiveness Analysis | Infectious Diseases | Costing Methods | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
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 | Cost-Effectiveness Analysis | Infectious Diseases | 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 | Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | 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…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | North America | Latin America & Caribbean -
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 | Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | Health/Medicine | Global -
ArticlePublication 2019Decision-Making for Universal Access to Tuberculosis Diagnosis In India
The authors evaluated the costs of centralized and decentralized testing for tuberculosis with Xpert MTB/RIF …
The authors evaluated the costs of centralized and decentralized testing for tuberculosis with Xpert MTB/RIF (Xpert), a WHO-endorsed test. They used an agent-based simulation of TB transmission in a hypothetical representative region in India to assess the impact and cost-effectiveness of various strategies to provide universal access to diagnosis and drug susceptibility testing (DST) for tuberculosis. The authors found that decentralization was most favorable compared to centralized testing when volume at decentralized facilities was high,…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Asia & Pacific -
ArticlePublication 2019POC Diagnosis of TB With Truenat Assay: CEA for India's Public Sector
Using a microsimulation model, the authors compared four TB diagnostic strategies for HIV-negative adults with …
Using a microsimulation model, the authors compared four TB diagnostic strategies for HIV-negative adults with presumptive TB in order to evaluate the potential cost-effectiveness of strategies that incorporate Truenat, a molecular assay that rapidly detects TB and rifampicin-resistance. They projected life expectancy, costs, incremental cost-effectiveness ratios (ICERs), and 5-year budget impact of deploying Truenat POC in India's public sector. Used at the point-of-care in India, Truenat for TB diagnosis should improve linkage-to-care, increase life expectancy,…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Asia & Pacific -
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 | Cost-Effectiveness Analysis | Infectious Diseases | Decision Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticleWeb Portal 2017PLOS Collection: Economic Efficiency of HIV Services
In order to maximize the value for money for HIV services and increase efficiency without …
In order to maximize the value for money for HIV services and increase efficiency without sacrificing quality, robust and up-to-date data on costs, efficiency and its determinants are needed. This PLOS collection, Economic Efficiency of HIV Services, presents recent, high-quality evidence from low- and middle-income countries on costs and technical efficiency of HIV services and their determinants. These data contribute to the current discussion on optimizing resources for HIV services and can provide programmatic guidance for…
Operations Research | Cost-Effectiveness Analysis | Infectious Diseases | Priority Setting/Ethics | Costing Methods | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific