Assessing the Impact of Public Compliance on the Use of Non-pharmaceutical Intervention with Cost-Effectiveness Analysis on the Transmission Dynamics of COVID-19: Insight from Mathematical Modeling

Public health decision makers value interventions for their effects on overall health and health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates health inequality concerns into economic evaluation by accounting for how parameters, such as effectiveness, differ across population groups. A good understanding of how and when accounting for socioeconomic differences between groups affects the assessment of intervention impacts on overall health and health inequality could inform decision makers where DCEA would add most value. We interrogated 2 DCEA models of smoking and alcohol policies using first national level and then local authority level information on various socioeconomic differences in health and intervention use. Through a series of scenario analyses, we explored the impact of altering these differences on the DCEA results. When all available evidence on socioeconomic differences was incorporated, provision of a smoking cessation service was estimated to increase overall health and increase health inequality, while the screening and brief intervention for alcohol misuse was estimated to increase overall health and reduce inequality. Ignoring all or some socioeconomic differences resulted in minimal change to the estimated impact on overall health in both models; however, there were larger effects on the estimated impact on health inequality. Across the models, there were no clear patterns in how the extent and direction of socioeconomic differences in the inputs translated into the estimated impact on health inequality. Modifying use or coverage of either intervention so that each population group matched the highest level improved the impacts to a greater degree than modifying intervention effectiveness. When local level socioeconomic differences were considered, the magnitude of the impacts was altered; in some cases, the direction of impact on inequality was also altered.

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Global stability and cost-effectiveness analysis of COVID-19 considering the impact of the environment: using data from Ghana

Chaos Solitons & Fractals ◽

10.1016/j.chaos.2020.110103 ◽

2020 ◽

Vol 140 ◽

pp. 110103 ◽

Cited By ~ 10

Author(s):

Joshua Kiddy K. Asamoah ◽

Mark A. Owusu ◽

Zhen Jin ◽

F. T. Oduro ◽

Afeez Abidemi ◽

...

Keyword(s):

Cost Effectiveness ◽

Global Stability ◽

Cost Effectiveness Analysis ◽

Effectiveness Analysis ◽

Using Data ◽

The Impact

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A Systematic Review of WTA-WTP Disparity for Dental Interventions and Implications for Cost-Effectiveness Analysis

Healthcare ◽

10.3390/healthcare8030301 ◽

2020 ◽

Vol 8 (3) ◽

pp. 301

Author(s):

Pedram Sendi ◽

Arta Ramadani ◽

Nicola U. Zitzmann ◽

Michael M. Bornstein

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Health Gain ◽

Analytical Framework ◽

Health Condition ◽

Cost Effectiveness Analysis ◽

Cochrane Library ◽

Effectiveness Analysis ◽

Substantial Risk ◽

The Impact

Cost-effectiveness analysis is widely adopted as an analytical framework to evaluate whether health care interventions represent value for money, and its use in dentistry is increasing. Traditionally, in cost-effectiveness analysis, one assumes that the decision maker’s maximum willingness to pay (WTP) for health gain is equivalent to his minimum willingness to accept (WTA) monetary compensation for health loss. It has been documented in the literature that losses are weighted higher than equivalent gains, i.e., that WTA exceeds WTP for the same health condition, resulting in a WTA/WTP ratio greater than 1. There is a knowledge gap of published WTA/WTP ratios for dental interventions in the literature. We therefore conducted a (i) systematic review of published WTA-WTP estimates in dentistry (MEDLINE, Web of Science, Cochrane Library, London, UK) and (ii) a patient-level analysis of WTA/WTP ratios of included studies, and (iii) we demonstrate the impact of a WTA-WTP disparity on cost-effectiveness analysis. Out of 55 eligible studies, two studies were included in our review. The WTA/WTP ratio ranged from 2.58 for discontinuing water fluoridation to 5.12 for mandibular implant overdentures, indicating a higher disparity for implant rehabilitations than for dental public health interventions. A WTA-WTP disparity inflates the cost-effectiveness of dental interventions when there is a substantial risk of both lower costs and health outcomes. We therefore recommend that in these cases the results of cost-effectiveness analyses are reported using different WTA/WTP ratios in a sensitivity analysis.

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