Resources Repository
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ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Clinical Care | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Clinical Care | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Science/Technology | North America -
ArticlePublication 2007Economic Evaluation of Hepatitis B Vaccination in Low-Income Countries: Cost-Effectiveness Affordability Curves
In the face of uncertainties about both the health and economic consequences of a vaccine …
In the face of uncertainties about both the health and economic consequences of a vaccine program, as well as the availability and magnitude of resources needed to fund the program, cost-effectiveness affordability curves can provide information to decision-makers about the probability that a program will be both cost-effective and affordable: these are distinct but equally relevant considerations in resource-poor settings. This paper describes the application of this method to assess a hepatitis B vaccination program in the…
Health Systems | Costing Methods | Mathematical Models | State-Transition | Microsimulation | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ReviewPublication 2003Public Health Policy and Cost-Effectiveness Analysis
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to …
This chapter presents an overview of the uses for cost-effectiveness analysis and disease-simulation modeling to rigorously evaluate alternatives to reduce mortality from cervical cancer. Scientific advances have provided opportunities over time to revisit strategies for cervical cancer prevention. How to invest health resources wisely, such that public health benefits are maximized-and opportunity costs are minimized-is a critical question in the setting of enhanced cytologic screening methods, human papillomavirus DNA testing, and vaccine development. Developing sound…
Health Systems | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Global -
BookPublication 2003WHO Guide to Cost-Effectiveness Analysis
This 2003 guide provides a method of assessing the cost-effectiveness of health interventions for an …
This 2003 guide provides a method of assessing the cost-effectiveness of health interventions for an international audience. The authors aim to inform the policy maker and to maximize the generalizability of results across settings. Part I begins with a description of cost-effectiveness analysis. It then considers issues relating to study design, estimating costs, assessing health effects, discounting, uncertainty and sensitivity analysis, and reporting results. Part II provides examples to illustrate the principles in Part I. Detailed discussions…
Health Systems | Priority Setting/Ethics | Costing Methods | Health Outcomes | Evidence Synthesis | Mathematical Models | Cost-Effectiveness Analysis | Health/Medicine | Global -
ReviewPublication 2001Modeling for Health Care and Other Policy Decisions: Uses, Roles and Validity
This is a review article of the role of modeling approaches to guide decision making …
This is a review article of the role of modeling approaches to guide decision making in health care and other domains. The role of models to support recommendations on the cost-effective use of medical technologies and pharmaceuticals is controversial. At the heart of the controversy is the degree to which experimental or other empirical evidence should be required prior to model use. The authors argue that the controversy stems in part from a misconception that…
Health Systems | Priority Setting/Ethics | Evidence Synthesis | Mathematical Models | Technology Assessment | Environmental Health | Policy/Regulation | Business/Industry | Climate/Environment | Economics/Finance | Energy/Engineering | Government/Law | Health/Medicine | North America -
BookPublication 1996Cost-Effectiveness in Health and Medicine, 1st Edition
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and …
In 1993, the US Public Health Service convened a panel of 13 nongovernment scientists and scholars with expertise in economics, clinical medicine, ethics, and statistics to review the state of cost-effectiveness analysis and to develop recommendations for its conduct and use in health and medicine. Publishing their results in 1996, they proposed the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. The panel recommended analysts include a "reference-case"…
Health Systems | Preferences/Values | Priority Setting/Ethics | Costing Methods | Health Outcomes | Evidence Synthesis | Value of Information | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
ReviewPublication 1978Basic Principles of ROC Analysis
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the …
The limitations of diagnostic "accuracy" as a measure of decision performance require introduction of the concepts of the "sensitivity" and "specificity" yet even these do not provide a unique description of diagnostic performance because they depend on the arbitrary selection of a decision threshold. The receiver operating characteristic (ROC) curve is shown to be a simple yet complete empirical description of this decision threshold effect, indicating all possible combinations of the relative frequencies of the…
Clinical Care | Test Performance | Health/Medicine -
BookPublication 1978Swine Flu Affair: Decision-Making on a Slippery Disease
This report from the Institute of Medicine, The Swine Flu Affair: Decision-Making on a Slippery …
This report from the Institute of Medicine, The Swine Flu Affair: Decision-Making on a Slippery Disease, was written to review and critique the decisions made around the 1976 swine flu threat. In 1976, a small group of soldiers at Fort Dix were infected with a swine flu virus that was deemed similar to the virus responsible for the great 1918-19 world-wide flu pandemic. The U.S. government initiated an unprecedented effort to immunize every American against…
Health Systems | Decision Analysis | Risk Analysis | Infectious Diseases | Policy/Regulation | Health/Medicine | Science/Technology | North America