Resources Repository
-
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Cost-Effectiveness Analysis | Microsimulation | Infectious Diseases | Health/Medicine | Global | Sub-Saharan Africa -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
Value of Information | State-Transition | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | North America | Europe -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Cost-Effectiveness Analysis | Microsimulation | Chronic Disease/Risk | Clinical Care | Health/Medicine | 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,…
Cost-Effectiveness Analysis | Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Infectious Diseases | Global -
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 | Mathematical Models | Microsimulation | Infectious Diseases | North America | Latin America & Caribbean -
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…
Cost-Effectiveness Analysis | Preferences/Values -
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…
Cost-Effectiveness Analysis | Preferences/Values | Chronic Disease/Risk | North America -
ArticlePublication 2022WHO ACTION-I Trial in Low Resource Countries
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk …
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk of early preterm birth using data from a multicentre, randomized, placebo-controlled trial in Bangladesh, India, Kenya, Nigeria, and Pakistan. Primary cost data were collected in 28 hospitals across the 5 countries. A decision tree model was used to compare dexamethasone treatment to no intervention from a health-care sector perspective. Administration of dexamethasone averted 38 neonatal deaths per 1000 woman–baby units…
Cost-Effectiveness Analysis | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Child/Nutrition | Clinical Care | Global | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2022Healthcare Cost of Overweight & Obesity in South Africa
This analysis estimates the healthcare cost associated with treatment of weight-related conditions from the perspective …
This analysis estimates the healthcare cost associated with treatment of weight-related conditions from the perspective of the South African public sector payer. The authors report that the total cost of overweight and obesity is estimated to be ZAR33,194 million in 2020, representing approximately 15% of government health expenditure and equivalent to 0.67% of GDP. This analysis is an example of a bottom-up gross costing approach. The study draws South African data from multiple sources to estimate…
Cost-Effectiveness Analysis | Costing Methods | Chronic Disease/Risk | Health Systems | Health/Medicine | Sub-Saharan Africa