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…
Evidence Synthesis | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | 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…
Microsimulation | Priority Setting/Ethics | Infectious Diseases | Sub-Saharan Africa -
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 -
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).…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
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…
Microsimulation | Mathematical Models | Cost-Effectiveness Analysis | 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…
Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2019Estimating the Total Incidence of Global Childhood Cancer: A Simulation-Based Analysis
This study describes the development of a microsimulation model to simulate childhood cancer incidence for …
This study describes the development of a microsimulation model to simulate childhood cancer incidence for 200 countries/territories, taking into account trends in population growth and urbanicity, geographical variation in cancer incidence, and health system barriers to access and referral that contribute to underdiagnosis. The model was calibrated to publicly available cancer registry data, and the total incidence of childhood cancer (diagnosed and undiagnosed) was estimated for each country in 2015 and projections made to 2030.…
Microsimulation | Health Outcomes | Child/Nutrition | Chronic Disease/Risk | Health Systems | Global -
ArticlePublication 2019Global Childhood Cancer Survival Estimates and Priority-Setting: A Simulation-Based Analysis
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of …
This modelling study provides estimates of global childhood cancer survival, accounting for the impact of multiple factors that affect cancer outcomes in children. The authors developed a microsimulation model to simulate childhood cancer survival for 200 countries/territories, accounting for clinical and epidemiologic factors, including country-specific treatment variables, such as availability of chemotherapy, radiation, and surgery, and calibrated the model to empirical data from the CONCORD-2 and CONCORD-3 studies using an Approximate Bayesian Computation approach. The…
Microsimulation | Priority Setting/Ethics | Health Outcomes | Child/Nutrition | Chronic Disease/Risk | Clinical Care | Global -
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…
Calibration/Validation | Health Outcomes | Mathematical Models | Chronic Disease/Risk | Social Determinants | North America