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…
Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | 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…
Latin America & Caribbean | Priority Setting/Ethics | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2017Estimated Economic Impact of Vaccinations in 73 LMIC, 2001-2020
This analysis estimates the economic impact likely to be achieved by efforts to vaccinate against 10 …
This analysis estimates the economic impact likely to be achieved by efforts to vaccinate against 10 vaccine-preventable diseases between 2001 and 2020 in 73 low- and middle-income countries largely supported by Gavi, the Vaccine Alliance. The authors used health impact models to estimate the economic impact of achieving forecasted coverages for vaccination against Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae and yellow fever. In…
State-Transition | Latin America & Caribbean | Health Outcomes | Dynamic Transmission | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | 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…
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 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 -
ArticlePublication 2013Estimated Mortality Impact of Vaccinations 2011–2020 in 73 GAVI Alliance Countries
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted …
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted by the GAVI Alliance and the Bill & Melinda Gates Foundation to estimate the impact of vaccination in 73 countries supported by the GAVI Alliance. The number of deaths averted in persons projected to be vaccinated during 2011–2020 was estimated for ten antigens: hepatitis B, yellow fever, Haemophilus influenzae type B (Hib), Streptococcus pneumoniae, rotavirus, Neisseria meningitidis serogroup A, Japanese…
State-Transition | Latin America & Caribbean | Health Outcomes | Mathematical Models | Dynamic Transmission | Microsimulation | Infectious Diseases | Global Governance | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2010Clinical Benefits, Costs, and Cost-Effectiveness of Neonatal Intensive Care in Mexico
This article reports on a study to estimate the clinical outcomes, costs, and cost-effectiveness of …
This article reports on a study to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico. The authors conducted a cost-effectiveness analysis using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the…
State-Transition | Latin America & Caribbean | Cost-Effectiveness Analysis | Child/Nutrition | Health Systems | Clinical Care | Health/Medicine -
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…
State-Transition | Latin America & Caribbean | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2009Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Mexico City
This study evaluated the health and economic outcomes associated with three alternative first-trimester abortion techniques …
This study evaluated the health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City using a computer-based model to simulate induced abortion and its potential complications. Strategies included alternative modalities for first-trimester pregnancy termination: hospital-based dilatation and curettage (D&C), hospital-based manual vacuum aspiration (MVA), clinic-based MVA and medical abortion using vaginal misoprostol. Outcomes included number of complications, lifetime costs, life expectancy, and quality-adjusted life expectancy. Assuming all options were equally available,…
State-Transition | Latin America & Caribbean | Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health/Medicine