In this lecture Prof. David McCoy will discuss the difficulties and challenges inherent in making plans to scale-up and improve MNCH services. It will outline a set of eight tensions and five challenges that policymakers and planners have to consider in ensuring optimal plans and approaches to priority-setting. It will demonstrate the value of data and evidence, but also point to their limitations.
OPM aims to provide evidence based policy support to governments. OPM has been contracted by the World Bank to support the Government of Swaziland in reforming its health financing system. As a result OPM undertook a series of 11 technical analysis (including fiscal space analysis which will be discussed in the presentation, but also benefit incidence analysis, feasibility study of introducing social health insurance, technical efficiency, etc). Based on this analysis, OPM made a series of evidence based recommendations to the government, expecting its approach to be so thoroughly supported by its technical input that there would be little dispute as to the way forward. Yet political priorities were in disagreement to the recommendations provided, which led to extensive negotiations and soul searching from OPM’s side: should we agree on supporting a policy reform which we don’t agree with from a technical perspective? Nouria will present some of the technical work we have undertaken as well as discuss the role of consultants in navigating the political and technical spheres simultaneously.
This session will provide an insight into NICE and the requirements for a HTA submission, the approach taken in the cost-effectiveness analysis, challenges faced and how they were approached, and the outcome of the submission. In addition, a practical example will be provided with a cost-effectiveness model walkthrough in Microsoft Excel.
Using recent policy-oriented work as a point of departure - will discuss the cost-effectiveness of and economic returns to Hepatitis C control policies, which have been transformed in recent years by the arrival of highly effective antiviral drugs and availability of these drugs at steep discounts across low- and middle-income countries. The talk will consider challenges for cost-effectiveness analysis arising from the very slow disease progression (typically there are several decades between infection and the onset of severe liver disease, and only about a quarter of people chronically infected die because of Hepatitis C), and discuss how to incorporate economic returns to health investments in a policy evaluation.
Bayesian methods are well-suited for addressing decision-making problems as they can explicitly account for all forms of uncertainty in the decision process. A substantial source of uncertainty, especially in cost-effectiveness trial data, is the presence of a relevant proportion of missing data (over 25%) in the outcomes that must be taken into account through appropriate methods. After a brief introduction to the missing data problem in economic evaluations, we illustrate the potential advantages of using Selection and Hurdle models to explore alternative missing not at random (MNAR) assumptions for the effectiveness and cost data in a RCT study and assess their impact on the conclusions from a decision-maker perspective.
This lecture will discuss the difficulties and challenges inherent in making plans to scale-up and improve MNCH services. It will outline a set of eight tensions and five challenges that policymakers and planners have to consider in ensuring optimal plans and approaches to priority-setting. It will demonstrate the value of data and evidence, but also point to their limitations.
There are limited resources available to finance healthcare, particularly in low- and middle-income countries. Tuberculosis (TB) is a leading cause of death and morbidity worldwide, and has historically been underfunded. Modelling the TB epidemic and its associated costs is essential to guide decision making, in order to help reach the national and international eradication goals. In this seminar, Dr Lara Goscè and Mr Gerard Abou-Jaoude will introduce the TB model developed at UCL which fits into the BALLSD optimisation algorithm to create Optima-TB. Examples of how data is used to inform the model, results from pilot country studies, and how these are eventually used will all be covered.
The MenSS trial was a trial to assess the feasibility of conducting a full randomised control trial of a website to improve condom use in young men recruited from sexual health clinics. This seminar will discuss the economic evaluation conducted as part of the feasibility trial. It will look at issues such as missing data, the impact of using different outcomes in the denominator of the cost-effectiveness analysis and collecting costs using self-completed questionnaires versus patient files.