Resources Repository
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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…
Mathematical Models | Latin America & Caribbean | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2022Spatial-Mechanistic Model to Estimate Sub-National Tuberculosis Burden in Brazilian Municipalities
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas …
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas of highest need. This study developed an approach for generating small area estimates of TB incidence, and the fraction of individuals missed by routine case detection, based on available notification and mortality data. The approach is demonstrated by estimating TB outcomes for 5568 municipalities in Brazil, revealing substantial subnational differences in disease burden and other metrics useful for designing high-impact…
Mathematical Models | Latin America & Caribbean | Health Outcomes | Infectious Diseases | 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…
Mathematical Models | Latin America & Caribbean | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | North America -
ArticlePublication 2016Mexico's SSB Tax Policy Impact on Diabetes and Cardiovascular Disease: Modeling Study
In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce …
In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD). In this analyses, a computer simulation model of CVD was used to project potential long-range health and economic impacts of SSB taxation in Mexico. Two main scenarios were modeled: (1) a 10% reduction in SSB consumption (corresponding to the reduction observed after tax implementation) and…
Mathematical Models | Latin America & Caribbean | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Food/Agriculture | Government/Law | Health/Medicine -
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…
Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2016Funding Gap for Immunization Across 94 Low- and Middle-Income Countries
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 …
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 low- and middle-income countries over the five-year period of 2016–2020. Vaccine financing by country governments, GAVI, and other development sources was forecasted for vaccine, supply chain, and service delivery based on an analysis of comprehensive multi-year plans together with a series of scenarios. The authors found that that delivery of full vaccination programs across the 94 countries would result in a total…
Mathematical Models | Latin America & Caribbean | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Global Governance | 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…
Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Europe | Asia & Pacific -
ArticlePublication 2016Cost-Effectiveness of Routine Vaccination With a Live-Attenuated Dengue Vaccine: Model Comparison
Large Phase III trials across Asia and Latin America have demonstrated the efficacy of a recombinant, …
Large Phase III trials across Asia and Latin America have demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 months following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. This paper reports predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine…
Mathematical Models | Latin America & Caribbean | Dynamic Transmission | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Health Systems | Global Governance | Climate/Environment | Economics/Finance | Health/Medicine | 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;…
Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific