Resources Repository
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Working PaperPublication 2024Economic Evaluation Primer
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence …
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence needed to support sound policy decisions. In low- and middle-income countries, where resources are especially scarce and needs are very great, such decisions are exceptionally difficult. In these settings, economic evaluation can be particularly useful in determining how to best improve health and welfare. Typically, cost-effectiveness analysis (CEA) is used to prioritize interventions within the health care sector. This approach…
Priority Setting/Ethics | Costing Methods | Health Outcomes | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Policy/Regulation | Global -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Evidence Synthesis | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Economics/Finance | Health/Medicine | Global | Asia & Pacific -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Maternal/Reproductive Health | Clinical Care | Health/Medicine | Sub-Saharan Africa -
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 | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | Health/Medicine | Global | North America -
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,…
Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Global -
ReviewPublication 2022Systematic Review of Economic Evaluations of COVID-19 Interventions: Non-Health Impacts and Distributional Issues
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether …
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether they incorporated non-health impacts and distributional concerns. Among the 70 articles included, more than half (56%) included at least one non-health impact, although only 21% incorporated non-economic consequences. Only 17% examined subgroups of interest. The median ICER for the entire sample was $67,000/quality-adjusted life-year (QALY) (interquartile range [IQR] $9000-$893,000/QALY). Interventions including a pharmaceutical component yielded a median ICER of $93,000/QALY (IQR…
Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2022Estimating Joint Health State Utilities
Estimating health utility for a health state defined by a single health condition is relatively …
Estimating health utility for a health state defined by a single health condition is relatively straightforward but becomes more complicated when 2 or more health conditions co-occur. Estimating health utility for so-called “joint health states” is particularly critical for health conditions that commonly co-occur with other conditions or for treatments in which adverse events are common or serious. In these cases, ignoring the utility loss associated with the joint health state can bias CEA results…
Preferences/Values | Cost-Effectiveness Analysis -
ArticlePublication 2022Health Utility of Drinkers' Family Members
Problematic alcohol use is known to harm individuals surrounding the drinker. This study described the …
Problematic alcohol use is known to harm individuals surrounding the drinker. This study described the health utility of people who reported having a family member(s) whom they perceived as a “problem drinker.” Using a US population dataset, and adjusting for other drinking-related factors, perceiving a family member as a problem drinker was associated with lower health utility on the order of 0.033 (P < 0.001) for a spouse/partner to 0.023 (P < 0.001) for a…
Preferences/Values | Cost-Effectiveness Analysis | Chronic Disease/Risk | North America