The cost‐effectiveness of hepatitis C virus elimination in low‐ and middle‐income countries

Despite the advent of safe and highly effective COVID-19 vaccines, pervasive inequities in global distribution persist. In response, multinational partners have proposed programs to allocate vaccines to low- and middle-income countries (LMICs). Yet, there remains a substantial funding gap for such programs. Further, the optimal vaccine supply is unknown and the cost-effectiveness of investments into global vaccination programs has not been described. We used a validated COVID-19 simulation model8 to project the health benefits and costs of reaching 20%-70% vaccine coverage in 91 LMICs. We show that funding 20% vaccine coverage over one year among 91 LMICs would prevent 294 million infections and 2 million deaths, with 26 million years of life saved at a cost of US$6.4 billion, for an incremental cost effectiveness ratio (ICER) of US$250/year of life saved (YLS). Increasing vaccine coverage up to 50% would prevent millions more infections and save hundreds of thousands of additional lives, with ICERs below US$8,000/YLS. Results were robust to variations in vaccine efficacy and hesitancy, but were more sensitive to assumptions about epidemic pace and vaccination costs. These results support efforts to fund vaccination programs in LMICs and complement arguments about health equity, economic benefits, and pandemic control11.

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Cost and Cost-effectiveness of eLearning Interventions for Healthcare Workers in Low- and Middle-income Countries: a Protocol for a Systematic Review and Meta-analysis

10.21203/rs.3.rs-951427/v1 ◽

2021 ◽

Author(s):

Nonjabulo Gwala ◽

Thembelihle Patricia Dlungwane ◽

Sphamandla Nkambule ◽

Tivani Mashamba-Thompson

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Healthcare Workers ◽

Professional Training ◽

Meta Analysis ◽

Middle Income ◽

Worker Training ◽

Middle Income Countries ◽

The Cost ◽

Low And Middle Income

Abstract BackgroundIn recent years, the shift from traditional face-to-face teaching methods to eLearning methods has shown to improve professional training, particularly for the health workers in achieving necessary specialised worker training. However, there is a insufficient evidence on the costs and cost-effectiveness of designing and deploying eLearning interventions for healthcare workers in low- and middle-income countries.MethodsThe study protocol was developed and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The Cochrane Handbook for Systematic Reviews of Interventions will be used to guide the conduct of the proposed systematic review and meta-analysis. Systematic literature searches will be conducted using the EBSCOhost platform ( Academic Search Complete, ERIC, health source: nursing/academic edition, MEDLINE with Full Text, OpenDissertations), Google Scholar, and the following databases: Web of Science, PubMed and ProQuest databases, evaluating the cost and cost-effectiveness of e-learning interventions for healthcare workers in low- and middle-income countries. The searches will be open to peer-reviewed articles published in all languages and no restriction in publication year. We will further evaluate the cost-effectiveness by determining heterogeneity in the content, if feasible we will do a meta-analysis using Meta- Easy Excel software tools. We will use OR and 95% CIs as measures of effect for dichotomous outcomes. As for continuous outcomes, we will use standardised mean differences and 95% CIs. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of the evidence across outcomes. PRISMA-P will be used to report the findings of this systematic review and meta-analysis.DiscussionThis systematic review target to deliver complete evidence of cost and the cost-effectiveness of eLearning interventions for healthcare worker training. The study will be disseminated through the publication of the manuscript and policy brief in an appropriate journal and shared with the relevant stakeholders through conference presentations, discussions and seminars.Protocol registrationPROSPERO ID: 271180

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The Cost-Effectiveness of Visual Triage of Human Papillomavirus–Positive Women in Three Low- and Middle-Income Countries

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-16-0787 ◽

2017 ◽

Vol 26 (10) ◽

pp. 1500-1510 ◽

Cited By ~ 7

Author(s):

Nicole G. Campos ◽

Jose Jeronimo ◽

Vivien Tsu ◽

Philip E. Castle ◽

Mercy Mvundura ◽

...

Keyword(s):

Human Papillomavirus ◽

Cost Effectiveness ◽

Middle Income ◽

Middle Income Countries ◽

The Cost ◽

Low And Middle Income

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A Systematic Review of Economic Evaluations of Chemoprophylaxis for Tuberculosis

Journal of Tropical Medicine ◽

10.1155/2011/130976 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Shraddha Chavan ◽

David Newlands ◽

Cairns Smith

Keyword(s):

Cost Effectiveness ◽

Age Groups ◽

Latent Tuberculosis ◽

Evidence Base ◽

Economic Evaluations ◽

Middle Income ◽

Policy Makers ◽

Middle Income Countries ◽

The Cost ◽

Low And Middle Income

Since treatment of active disease remains the priority for tuberculosis control, donors and governments need to be convinced that investing resources in chemoprophylaxis provides health benefits and is good value for money. The limited evidence of cost effectiveness has often been presented in a fragmentary and inconsistent fashion.Objective. This review is aimed at critically reviewing the evidence of cost effectiveness of chemoprophylaxis against tuberculosis, identifying the important knowledge gaps and the current issues which confront policy makers.Methods. A systematic search on economic evaluations for chemoprophylaxis against tuberculosis was carried out, and the selected studies were checked for quality assessment against a standard checklist.Results. The review provides evidence of the cost effectiveness of chemoprophylaxis for all age groups which suggests that current policy should be amended to include a focus on older adults. Seven of the eight selected studies were undertaken wholly in high income countries but there are considerable doubts about the transferability of the findings of the selected studies to low and middle income countries which have the greatest incidence of latent tuberculosis infection.Conclusion. There is a pressing need to expand the evidence base to low and middle income countries where the vast majority of sufferers from tuberculosis live.

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Improving access to the treatment of hepatitis C in low- and middle-income countries: evaluation of a patient assistance programme

International Journal of Clinical Pharmacy ◽

10.1007/s11096-020-01202-1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Salamat Ali ◽

Tofeeq Ur-Rehman ◽

Mashhood Ali ◽

Sayeed Haque ◽

Faisal Rasheed ◽

...

Keyword(s):

Cost Effectiveness ◽

Hepatitis C ◽

Average Cost ◽

Cost Effectiveness Ratio ◽

Hepatitis C Treatment ◽

Middle Income ◽

Middle Income Countries ◽

Assistance Programme ◽

Patient Assistance ◽

Low And Middle Income

AbstractBackground Modern antiviral treatments have high cure rates against the hepatitis C virus however, the high cost associated with branded medicines and diagnostic tests, have resulted in poor access for many low-income patients residing in low-and-middle-income countries. Objective This study aimed to evaluate the role of a patient assistance programme and generic medicines in improving access to treatment of low-income hepatitis C patients in a low-and-middle-income country. Setting A major teaching public hospital in Islamabad, Pakistan. Methods Hepatitis C patients who presented and enrolled for the patient assistance programme during 12 months (1st July 2015 and 30th June 2016) were included. Demography, prescription characteristics, the total costs of Hepatitis C treatment, medicine cost supported by the programme, out-of-pocket cost borne by the patient and average cost effectiveness ratio per sustained virologic response were calculated and compared for different generic and branded regimens. Main outcome measure cost contribution of patient assistance programme. Results A total of 349 patients initiated the treatment through the programme and of those 334 (95.7%) completed the prescribed treatment. There were 294 (88.02%) patients who achieved sustained virologic response. Patient assistance programme contributed medicines cost averaging 60.28–86.26% of the total cost of treatment ($1634.6) per patient. The mean (SE) cost per patient for generic option (Sofosbuvir/Ribavirin) was the lowest [$658.36 (22.3) per patient, average cost effectiveness ratio = $720.1/SVR] than branded option (Sovaldi/Ribavirin) [$2218.66 (37.6) per patient, average cost effectiveness ratio = $2361.8/SVR] of the three available treatment regimens. From patients’ perspectives, the mean (SE) out-of-pocket cost was $296.9 (6.7) which primarily included diagnostic cost (69.9%) of the total cost. Conclusions Patient assistance programme, combined with generic brands of newer hepatitis C treatment offered a significant reduction in cost and widens access to hepatitis C treatment in low-and middle-income countries. However, substantial out-of-pocket costs of the treatment presents an important barrier for service access. There is a scope to widen such financial assistance programme to offer other costs attributed to patients, specifically for diagnosis, to widen service use in low-and-middle-income countries.

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