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Tytuł pozycji:

Are low and middle-income countries prioritising high-value healthcare interventions?

Tytuł:
Are low and middle-income countries prioritising high-value healthcare interventions?
Autorzy:
Leech AA; Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
Kim DD; Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
Cohen JT; Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
Neumann PJ; Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
Źródło:
BMJ global health [BMJ Glob Health] 2020 Feb 04; Vol. 5 (2), pp. e001850. Date of Electronic Publication: 2020 Feb 04 (Print Publication: 2020).
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Original Publication: [London] : BMJ Publishing Group Ltd, [2016]-
MeSH Terms:
Papillomavirus Infections*
Papillomavirus Vaccines*
Africa South of the Sahara/epidemiology ; Developing Countries ; Female ; Health Priorities ; Humans ; Pregnancy
References:
Health Syst Reform. 2016 Jan 2;2(1):39-50. (PMID: 31514661)
Health Econ Policy Law. 2006 Jan;1(Pt 1):79-90. (PMID: 18634704)
BMJ Glob Health. 2018 Apr 9;3(2):e000607. (PMID: 29662689)
PLoS Negl Trop Dis. 2017 Aug 3;11(8):e0005424. (PMID: 28771480)
Value Health. 2016 Dec;19(8):910-912. (PMID: 27987639)
PLoS One. 2018 Jun 1;13(6):e0198622. (PMID: 29856849)
Value Health. 2017 Jan;20(1):60-66. (PMID: 28212971)
Bull World Health Organ. 2016 Jun 1;94(6):462-7. (PMID: 27274598)
Glob Heart. 2012 Mar;7(1):13-34. (PMID: 25691165)
Contributed Indexing:
Keywords: health economics; health policy
Substance Nomenclature:
0 (Papillomavirus Vaccines)
Entry Date(s):
Date Created: 20200306 Date Completed: 20210624 Latest Revision: 20231113
Update Code:
20240105
PubMed Central ID:
PMC7042606
DOI:
10.1136/bmjgh-2019-001850
PMID:
32133187
Czasopismo naukowe
Introduction: Since resources are finite, investing in services that produce the highest health gain 'return on investment' is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.
Methods: We used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008-2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.
Results: We identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.
Conclusion: Our findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.
Competing Interests: Competing interests: JTC has grants for work conducted on behalf of Amgen, Biogen and Janssen Pharmaceuticals and has lectured on the use of simulation for Pfizer. JTC has also consulted for AbbVie, Precision Health Economics, Sage Therapeutics and Sarepta. PN has held one-time roles on the advisory boards on health economics topics for Avexis, AbbVie, Research Triangle Institute, Merck, Genentech, Bluebird Bio and Novo Nordisk. PN serves on the advisory board for the Congressional Budget Office and has consulted for Precision Health Economics.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

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