Resources Repository
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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 | Economics/Finance | Health Systems | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Global -
ArticlePublication 2016Departures from Cost-Effectiveness Recommendations: Health System Constraints
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality …
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality decision makers may be faced with numerous other constraints. The objective of this article is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance;…
Economics/Finance | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Economics/Finance | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2013Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
Although gastric cancer has declined dramatically in the US, the disease remains the second leading …
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence. The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which…
Calibration/Validation | Culture/Society | Chronic Disease/Risk | Microsimulation | Social Determinants | Health/Medicine | North America -
ArticlePublication 2011Health and Economic Impact of HPV 16/18 Vaccination and Cervical Cancer Screening in Eastern Africa
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe …
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, they assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30, they assessed only screening (with HPV DNA testing up to three times per lifetime or VIA…
Calibration/Validation | Economics/Finance | Chronic Disease/Risk | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Clinical Care | Health/Medicine | Science/Technology | Sub-Saharan Africa -
ArticlePublication 2010Health and Economic Impact of Rotavirus Vaccination in GAVI-Eligible Countries
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately …
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately borne by children in low-income countries. Motivated by the global recommendation by the WHO that all countries include infant rotavirus vaccination in their national immunization programs, the objective of this analysis was to provide information on the expected health, economic and financial consequences of rotavirus vaccines in the 72 GAVI support-eligible countries. The authors synthesized population-level data from various sources (primarily from…
Health Outcomes | Economics/Finance | Child/Nutrition | Mathematical Models | State-Transition | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Calibration/Validation | Economics/Finance | Chronic Disease/Risk | Dynamic Transmission | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Clinical Care | Health/Medicine | North America -
ArticlePublication 2007Economic Evaluation of Hepatitis B Vaccination in Low-Income Countries: Cost-Effectiveness Affordability Curves
In the face of uncertainties about both the health and economic consequences of a vaccine …
In the face of uncertainties about both the health and economic consequences of a vaccine program, as well as the availability and magnitude of resources needed to fund the program, cost-effectiveness affordability curves can provide information to decision-makers about the probability that a program will be both cost-effective and affordable: these are distinct but equally relevant considerations in resource-poor settings. This paper describes the application of this method to assess a hepatitis B vaccination program in the…
Costing Methods | Economics/Finance | Health Systems | Mathematical Models | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Sub-Saharan Africa