Resources Repository
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ArticlePublication 2018HTA and MCDA Solely or Combined? The Case of Priority-Setting in Colombia
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related …
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related to setting priorities. Two methods, Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as tools to assist in informed decision-making, but both have advantages and disadvantages. Colombia established a Health Technology Assessment Institute in 2012. The authors discuss challenges faced by the Colombian health system, characteristics of HTA in Colombia and the potential benefits and drawbacks of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Latin America & Caribbean | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2017Getting it Right When Budgets are Tight: Prioritizing Responses to HIV Epidemics
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and …
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain.The authors examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Latin America & Caribbean | Costing Methods | Mathematical Models | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2016Country-Level Cost-Effectiveness Thresholds
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income …
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Latin America & Caribbean | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Europe | Asia & Pacific -
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;…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Latin America & Caribbean | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2014Cost-Effectiveness of Female HPV Vaccination in 179 Countries: A PRIME Modelling Study
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), …
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), used to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. The PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programs…
Cost-Effectiveness Analysis | Calibration/Validation | Latin America & Caribbean | Health Outcomes | Mathematical Models | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Global | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in Latin America and the Caribbean
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted …
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for human papillomavirus (HPV) vaccination of young adolescent girls using population and epidemiologic data for 33 countries in Latin America and the Caribbean (LAC). The authors found that an absolute reduction in lifetime cancer risk varied between countries, depending on incidence, proportion attributable to HPV-16 and 18, and population age-structure; for…
Cost-Effectiveness Analysis | Calibration/Validation | Latin America & Caribbean | Costing Methods | State-Transition | Microsimulation | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology -
ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Cost-Effectiveness Analysis | Calibration/Validation | Latin America & Caribbean | Microsimulation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine -
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…
Cost-Effectiveness Analysis | Latin America & Caribbean | Mathematical Models | Microsimulation | Infectious Diseases | North America -
ArticlePublication 2021Impact of COVID-19 on Cancer Diagnosis and Survival in Chile
This paper estimates the impact of the COVID-19 pandemic on delays in cancer diagnosis in …
This paper estimates the impact of the COVID-19 pandemic on delays in cancer diagnosis in Chile, using a microsimulation model of five cancers: breast, cervix, colorectal, prostate, and stomach. The model simulates cancer incidence and progression, as well as stage-specific cancer detection and survival probabilities, and was calibrated to empirical data on monthly detected cases, stage at diagnosis, and 5-year net survival. The analysis accounted for the impact of COVID-19 on month-by-month excess mortality and…
Calibration/Validation | Latin America & Caribbean | Health Outcomes | Microsimulation | Infectious Diseases | Chronic Disease/Risk