Resources Repository
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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…
Operations Research | Mathematical Models | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2021Employee Health Plans Powered by Analytics
This article describes a business model for the employee health plans of large firms to …
This article describes a business model for the employee health plans of large firms to bypass insurers and instead use direct contracts with hospitals which have been designated as centers of excellence. The authors propose methods of machine learning and data analytics to identify efficient and effective delivery systems, with the ultimate goal of improving health care quality.
Operations Research | Health Systems | North America -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Cost-Effectiveness Analysis | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | Health/Medicine | Global | North America -
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…
Cost-Effectiveness Analysis | Microsimulation | Infectious Diseases | Health/Medicine | Global | Sub-Saharan Africa -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Cost-Effectiveness Analysis | Microsimulation | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
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,…
Cost-Effectiveness Analysis | Mathematical Models | Microsimulation | Calibration/Validation | Decision 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…
Cost-Effectiveness Analysis | Mathematical Models | Microsimulation | Infectious Diseases | North America | Latin America & Caribbean -
ReviewPublication 2022Systematic Review of Economic Evaluations of COVID-19 Interventions: Non-Health Impacts and Distributional Issues
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether …
The authors conducted a systematic review of economic evaluations of COVID-19 interventions and assessed whether they incorporated non-health impacts and distributional concerns. Among the 70 articles included, more than half (56%) included at least one non-health impact, although only 21% incorporated non-economic consequences. Only 17% examined subgroups of interest. The median ICER for the entire sample was $67,000/quality-adjusted life-year (QALY) (interquartile range [IQR] $9000-$893,000/QALY). Interventions including a pharmaceutical component yielded a median ICER of $93,000/QALY (IQR…
Cost-Effectiveness Analysis | Evidence Synthesis | Infectious Diseases | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2022Estimating Joint Health State Utilities
Estimating health utility for a health state defined by a single health condition is relatively …
Estimating health utility for a health state defined by a single health condition is relatively straightforward but becomes more complicated when 2 or more health conditions co-occur. Estimating health utility for so-called “joint health states” is particularly critical for health conditions that commonly co-occur with other conditions or for treatments in which adverse events are common or serious. In these cases, ignoring the utility loss associated with the joint health state can bias CEA results…
Cost-Effectiveness Analysis | Preferences/Values