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.