Resources Repository
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ArticlePublication 2023Cost-Effectiveness of Novel TB Vaccines: A Modeling Study
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines …
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines in 105 low- and middle-income countries (LMICs) for a range of product characteristics and delivery strategies, compared to a ‘no-new-vaccine’ counterfactual. Vaccine scenarios considered two vaccine product profiles (one targeted at infants, one at adolescents/adults), both assumed to prevent progression to active TB. Vaccine introduction was estimated to require substantial near-term resources, offset by future cost-savings from averted TB burden.…
Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2021Distributional Accounting Impact Model of Tobacco Taxation
As with other ‘sin taxes’, tobacco taxes are generally regarded as a highly cost-effective mechanism …
As with other ‘sin taxes’, tobacco taxes are generally regarded as a highly cost-effective mechanism to reduce consumption while also considered to be regressive. This dichotomy undermines efforts to fully implement tobacco taxes at levels recommended by the WHO due to concerns of fairness. This article demonstrates when there are circumstances in which the impacts of additional tobacco taxes are not regressive, using a standard income-share accounting definition of tax burden. The authors apply mathematical…
Mathematical Models | Policy/Regulation -
ArticlePublication 2021Health Benefit Package Design
Policymakers face difficult choices over which health interventions to publicly finance. This article presents an …
Policymakers face difficult choices over which health interventions to publicly finance. This article presents an approach to health benefits package design that accommodates explicit tradeoffs between improvements in health and provision of financial risk protection. The authors designed a mathematical optimization model to balance gains in health and financial risk protection across candidate interventions when publicly financed. The optimal subset of interventions selected for inclusion was determined with bi-criterion integer programming conditional on a budget…
Mathematical Models | Priority Setting/Ethics | Global -
ArticlePublication 2020Data-Driven Management of Post-Transplant Medications
Organ-transplanted patients typically receive high amounts of immunosuppressive drugs as a mechanism to reduce their …
Organ-transplanted patients typically receive high amounts of immunosuppressive drugs as a mechanism to reduce their risk of organ rejection. However, because of the diabetogenic effect of these drugs, this practice exposes them to a greater risk of new-onset diabetes after transplantation (NODAT), and hence, becoming insulin dependent. This study develops effective medication management strategies to address the common conundrum of balancing the risk of organ rejection versus that of NODAT. The article presents a robust…
Mathematical Models | Operations Research | Chronic Disease/Risk | Health/Medicine | North America -
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…
Mathematical Models | Health Outcomes | Infectious Diseases | Health/Medicine | Latin America & Caribbean -
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 -
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…
Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | North America | Latin America & Caribbean -
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…
Mathematical Models | Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Clinical Care | Global | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2019Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories …
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI) in the United States. Self-reported BMI from the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias. Multinomial regressions were then fitted for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI <25), overweight (25 to…
Mathematical Models | Health Outcomes | Calibration/Validation | Chronic Disease/Risk | Social Determinants | North America