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ArticlePublication 2017Changing the South African National ART Guidelines: The Role of Cost Modelling
This analysis was motivated by the South African Department of Health's request to assess the …
This analysis was motivated by the South African Department of Health's request to assess the cost implications of adopting sets of ART guidelines issued by the World Health Organization between 2010 and 2016.Using data from large South African ART clinics (n = 24,244 patients), projections of patients in need of ART, and cost data from bottom-up cost analyses, the authors constructed a population-level health-state transition model with 6-monthly transitions between health states depending on patients’ age,…
State-Transition | Economics/Finance | Costing Methods | Infectious Diseases | Health Systems | Clinical Care | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Revealed Willingness-to-Pay vs. Standard Cost-Effectiveness Thresholds
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The …
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The use of CETs based on a country’s income per capita has been criticized for not being grounded in theory or evidence, especially in low and middle-income countries (LMICs). An alternative has been produced for South Africa, based on estimates of life years saved and the country’s committed HIV budget. The authors used a previously -published optimization method to estimate CETs,…
Cost-Effectiveness Analysis | Economics/Finance | Preferences/Values | Priority Setting/Ethics | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Cost-Effectiveness Analysis | Economics/Finance | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Cost-Effectiveness Analysis | Economics/Finance | Priority Setting/Ethics | Chronic Disease/Risk | Social Determinants | Environmental Health | Policy/Regulation | Climate/Environment | Energy/Engineering | Science/Technology | Asia & Pacific -
ArticlePublication 2017Policy Makers, the International Community and the Population: Case Study on HIV/AIDS
A four-period game is developed between a policy maker, the international community, and the population. …
A four-period game is developed between a policy maker, the international community, and the population. This research supplements, through implementing strategic interaction, earlier research analyzing "one player at a time." The first two players distribute funds between preventing and treating diseases. The population reacts by degree of risky behavior which may cause no disease, disease contraction, recovery, sickness/death. More funds to prevention implies less disease contraction but higher death rate given disease contraction. The cost…
Mathematical Models | Economics/Finance | Decision Psychology | Priority Setting/Ethics | Infectious Diseases | Health Systems | Global Governance | Government/Law | Health/Medicine | Global -
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…
Cost-Effectiveness Analysis | Economics/Finance | Priority Setting/Ethics | Health Systems | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Health Gains & Financial Protection from Ethiopian Mental Health Strategy: An ECEA
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed …
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed care for depression, bipolar disorder, schizophrenia and epilepsy as part of the mental and neurological package (MN) of the National Mental Health Strategy in Ethiopia. The following outcomes were estimated disaggregated across wealth quintiles: (1) healthy-life-years (HALYs) gained; (2) household out-of-pocket (OOP) expenditures averted (3) expected financial risk protection (FRP); and (4) productivity impact. The MN package is expected to…
Cost-Effectiveness Analysis | Economics/Finance | Costing Methods | Health Outcomes | Mental Health | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016An Extended CEA of Schizophrenia Treatment in India under Universal Public Finance
This paper evaluates the potential health and financial risk protection effects of a policy of …
This paper evaluates the potential health and financial risk protection effects of a policy of universal public finance (UPF) to treating schizophrenia in India. The study uses the extended cost effectiveness analysis framework across income quintiles. The results show financial protection benefits concentrated in the richest income quintiles, while health gains were concentrated among the poorest. The value of insurance is highest for the poorest income and decreases as the household income increases. In settings…
Cost-Effectiveness Analysis | Economics/Finance | Priority Setting/Ethics | Costing Methods | Mental Health | Health Systems | Clinical Care | Culture/Society | Health/Medicine | Asia & Pacific -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Cost-Effectiveness Analysis | Economics/Finance | Priority Setting/Ethics | Mental Health | Social Determinants | Health Systems | Health/Medicine | Global