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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 | Economics/Finance | Asia & Pacific | Latin America & Caribbean | Dynamic Transmission | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Health Systems | Global Governance | Climate/Environment | Health/Medicine -
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;…
Priority Setting/Ethics | Economics/Finance | Asia & Pacific | Latin America & Caribbean | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa -
ArticlePublication 2010Model Uncertainty in Economic Evaluation of Health Interventions: Rotavirus Vaccination in Vietnam
Motivated by observed discrepancies between 2 published studies on the cost-effectiveness of rotavirus vaccination in …
Motivated by observed discrepancies between 2 published studies on the cost-effectiveness of rotavirus vaccination in Vietnam, the authors' objectives were to illustrate a specific, systematic approach to assessing model (structure and process) uncertainty and to quantify explicitly the contributions of different sources of variation in the outputs of different studies that share the same research question. On the basis of a series of working definitions of key model elements, the authors developed 5 alternative computer…
Mathematical Models | Calibration/Validation | State-Transition | Economics/Finance | Asia & Pacific | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in the Asia Pacific Region
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, …
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for vaccination of young adolescent girls against human papillomavirus (HPV) types 16 and 18. The authors used population-based and epidemiologic data for 25 countries in Asia (22 GAVI-Alliance eligible countries, Thailand, China and Japan). They found that an absolute reduction in lifetime cancer risk varied across countries, depending on incidence,…
Microsimulation | Mathematical Models | Calibration/Validation | Economics/Finance | Asia & Pacific | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in Latin America and the Caribbean
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted …
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for human papillomavirus (HPV) vaccination of young adolescent girls using population and epidemiologic data for 33 countries in Latin America and the Caribbean (LAC). The authors found that an absolute reduction in lifetime cancer risk varied between countries, depending on incidence, proportion attributable to HPV-16 and 18, and population age-structure; for…
Microsimulation | Calibration/Validation | State-Transition | Economics/Finance | Latin America & Caribbean | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Science/Technology -
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…
Microsimulation | Mathematical Models | Economics/Finance | Latin America & Caribbean | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Food/Agriculture | Government/Law | Health/Medicine -
ArticlePublication 2016Health and Economic Benefits of Public Financing of Epilepsy Treatment in India
This study uses extended cost-effectiveness analysis (ECEA) to evaluate the impact of three scenarios of …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate the impact of three scenarios of publicly financed national epilepsy programs in India that provide (1) first line antiepilepsy drugs (AEDs), (2) first- and second-line AEDs, and (3) first- and second-line AEDs and surgery. Outcome measures include disability-adjusted life years (DALYs) averted, and cost per DALY averted. Economic benefit measures estimated include out-of-pocket (OOP) expenditure averted and money-metric value of insurance. All three scenarios represent a…
Priority Setting/Ethics | Microsimulation | Economics/Finance | Asia & Pacific | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2018Equity Impact Vaccines May Have on Averting Deaths and Medical Impoverishment
In this analysis, authors estimated the number of deaths averted and the number of cases …
In this analysis, authors estimated the number of deaths averted and the number of cases of medical impoverishment averted of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. The study found that vaccines administered between 2016 and 2030 would prevent 36 million deaths. Vaccines will have the greatest impact on reducing cases of poverty caused by hepatitis B, helping an estimated 14 million people avoid medical impoverishment. An…
Priority Setting/Ethics | Mathematical Models | Economics/Finance | Asia & Pacific | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Global Governance | Health/Medicine | Science/Technology | Sub-Saharan Africa | Middle East & North Africa -
ArticlePublication 2017Reduced Burden of Childhood Diarrheal Diseases through Increased Access to Water and Sanitation in India: Modeling Analysis
This analysis estimates the health and economic benefits of scaling up the coverage of piped …
This analysis estimates the health and economic benefits of scaling up the coverage of piped water and improved sanitation to a near-universal 95% level among Indian households. The authors used an agent-based microsimulation platform, IndiaSim, to model disease progression and individual healthcare-seeking behavior in India, and use ECEA to estimate health and economic outcomes over time. They found that scaling up access to piped water and improved sanitation could avert 43,352 diarrheal episodes and 68…
Priority Setting/Ethics | Microsimulation | Economics/Finance | Asia & Pacific | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Social Determinants | Environmental Health | Energy/Engineering | Health/Medicine | Science/Technology