Resources Repository
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ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Costing Methods | Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | 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 2020Broader Economic Value of School Feeding Programs
Globally, there are 370 million children receiving school meals every day. Coverage is least in …
Globally, there are 370 million children receiving school meals every day. Coverage is least in low-income countries, where the need is greatest and where program costs are viewed as high in comparison with the benefits to public health alone. This article explores the policy implications of including the returns of school feeding to other sectors in an economic analysis. The authors develop an economic evaluation methodology to estimate the costs and benefits of school feeding…
Costing Methods | Child/Nutrition | Global -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Priority Setting/Ethics | Microsimulation | Infectious Diseases | Sub-Saharan Africa -
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…
Priority Setting/Ethics | Mathematical Models | Global -
ArticlePublication 2021Incorporating Equity in Infectious Disease Modeling: Measles
Deterministic compartmental models of infectious diseases like measles typically reflect biological heterogeneities in the risk …
Deterministic compartmental models of infectious diseases like measles typically reflect biological heterogeneities in the risk of infection and severity to characterize transmission dynamics. Given the known association of socioeconomic status and increased vulnerability to infection and mortality, it is also critical that such models further incorporate social heterogeneities. This article explores the influence of integrating income-associated differences in parameters of traditional dynamic transmission models. The authors developed a measles “SIR” model, in which the
Priority Setting/Ethics | Dynamic Transmission -
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…
Health Outcomes | Mathematical Models | Infectious Diseases | Health/Medicine | Latin America & Caribbean -
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…
Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Global | Sub-Saharan Africa