Resources Repository
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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;…
Health/Medicine | Economics/Finance | Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Education/Labor | Government/Law | 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…
Health/Medicine | Economics/Finance | Latin America & Caribbean | Health Outcomes | Mathematical Models | State-Transition | Dynamic Transmission | Microsimulation | Infectious Diseases | Global Governance | Science/Technology | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
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…
Health/Medicine | Economics/Finance | Latin America & Caribbean | Health Outcomes | Mathematical Models | State-Transition | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
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…
Health/Medicine | Economics/Finance | Latin America & Caribbean | Costing Methods | State-Transition | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Science/Technology -
ArticlePublication 2007Cost Effectiveness of Interventions to Reduce Maternal Mortality in Mexico
This article, published in PloS One, uses maternal mortality data from Mexico to examine trends …
This article, published in PloS One, uses maternal mortality data from Mexico to examine trends in the provision of maternal health services and the trajectory towards reaching the Millennium Development Goal 5 (MDG 5). The authors developed a model of the natural history of pregnancy and pregnancy related complications and simulated a cohort of 15-year-old women over their lifetime based on national data. The model produced clinical outcomes, costs, and cost-effectiveness of the current standard…
Health/Medicine | Economics/Finance | Latin America & Caribbean | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health -
ArticlePublication 2022Spatial-Mechanistic Model to Estimate Sub-National Tuberculosis Burden in Brazilian Municipalities
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas …
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas of highest need. This study developed an approach for generating small area estimates of TB incidence, and the fraction of individuals missed by routine case detection, based on available notification and mortality data. The approach is demonstrated by estimating TB outcomes for 5568 municipalities in Brazil, revealing substantial subnational differences in disease burden and other metrics useful for designing high-impact…
Health/Medicine | Latin America & Caribbean | Health Outcomes | Mathematical Models | Infectious Diseases -
ArticlePublication 2022Distributional Effects of Tobacco Tax Increases across Mexico: An ECEA
This study examines the distributional impacts of a one-peso tobacco tax increase in Mexico, focusing …
This study examines the distributional impacts of a one-peso tobacco tax increase in Mexico, focusing on health, poverty, and financial outcomes at the subnational level. Utilizing an extended cost-effectiveness analysis, the research estimates various metrics such as life-years gained, smoking attributable deaths averted, treatment costs averted, and financial impacts by income group across five regions. Findings reveal that the tax increase would lead to significant benefits, including approximately 1.5 million smokers quitting across the regions,…
Health/Medicine | Latin America & Caribbean | Cost-Effectiveness Analysis | Policy/Regulation -
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…
Health/Medicine | Latin America & Caribbean | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation -
ArticlePublication 2018DALYS and QALYs – Does the Choice of Measure Matter?
This article discusses the measurement of health benefits as a key issue in health economic …
This article discusses the measurement of health benefits as a key issue in health economic evaluations. Authors adapted two previously published models, a Markov model for human papilloma virus (HPV) vaccination, and a pneumococcal vaccination deterministic model (PNEUMO) that reported outputs in QALYs to estimate DALYs in 3 settings, Argentina, Chile, and the United Kingdom. While the authors found that QALY gains were larger than DALYs avoided in all countries for HPV, differences using QALYs…
Health/Medicine | Latin America & Caribbean | Cost-Effectiveness Analysis | Infectious Diseases | Policy/Regulation | Europe