Economic evaluation of communicable disease interventions in developing countries: a critical review of the published literature

Abstract

Limited health care budgets have emphasized the need for providers to use resources efficiently. Accordingly, there has been a rapid increase in the number of economic evaluations of communicable disease health programmes in developing countries, as there is a need to implement evidence‐based policy decisions. However, given the prohibitive cost of many economic evaluations in low‐income countries, interest has also been generated in pooling data and results of previously published studies. Yet, our review demonstrated that very few published economic evaluations have been performed during 1984–1997 (n=107). Certain diseases and geographical areas have also been neglected. Of those studies published, appropriate analytic techniques have been inconsistently applied. In particular, there are four immediate concerns: the narrow perspective taken—dominance of the health care provider viewpoint and reliance on intermediate outcomes measures; bias—some costs were excluded from estimates; the lack of transparency—sources of data not identified; and the absence of a critical examination of findings—many papers failed to perform a sensitivity analysis. The usefulness of previously published economic evaluations to help make resource allocation choices on an individual basis and, therefore, for the purpose of international comparisons, pooling or meta‐analysis, has to be questioned in light of the results from this study. Copyright © 2000 John Wiley & Sons, Ltd.

Economic Evaluation of Health Interventions: A Critical Review

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies ( 8 , 14 ).…”

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies (8,14). Experimental and quasi-experimental studies were mainly used for the economic evaluation of health interventions.…”

Economic Evaluation of Health Interventions: A Critical Review

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies ( 8 , 14 ).…”

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies (8,14). Experimental and quasi-experimental studies were mainly used for the economic evaluation of health interventions.…”

Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries

“…In this current review, the majority of reviewed studies (47%) were poor and extremely poor quality and only 18% were good quality and 6% were excellent quality. These findings are in line with the results of research by Walker and Fox-Rushby 71 and Lee et al, 67 who also found a limited supply of good quality economic evaluation studies in developing countries. Based on the small number of publications found, it appears that health policies and plans in G.C.C are being made without sound economic evaluation data, which confirms findings by Maynard.…”

The state of health economics and pharmaceoconomics research in Russia: a systematic review

“…This may be explained by the fact that few Russian researchers are proficient in English to be able to publish independently in international journals or to collaborate with their foreign colleagues. There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium‐ and low‐income countries [52,53] . The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings [6,8,44] .…”

“…There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium-and low-income countries. [52,53] The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings. [6,8,44] There are several factors that may explain the limited number of health economic studies, including economic evaluations, in Russia including organisation and payment structure of the healthcare system, and limited expertise in economic evaluation.…”

Economic Evaluation of Health Interventions: A Critical Review

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies ( 8 , 14 ).…”

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies (8,14). Experimental and quasi-experimental studies were mainly used for the economic evaluation of health interventions.…”

Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries

“…In this current review, the majority of reviewed studies (47%) were poor and extremely poor quality and only 18% were good quality and 6% were excellent quality. These findings are in line with the results of research by Walker and Fox-Rushby 71 and Lee et al, 67 who also found a limited supply of good quality economic evaluation studies in developing countries. Based on the small number of publications found, it appears that health policies and plans in G.C.C are being made without sound economic evaluation data, which confirms findings by Maynard.…”

The state of health economics and pharmaceoconomics research in Russia: a systematic review

“…This may be explained by the fact that few Russian researchers are proficient in English to be able to publish independently in international journals or to collaborate with their foreign colleagues. There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium‐ and low‐income countries [52,53] . The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings [6,8,44] .…”

“…There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium-and low-income countries. [52,53] The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings. [6,8,44] There are several factors that may explain the limited number of health economic studies, including economic evaluations, in Russia including organisation and payment structure of the healthcare system, and limited expertise in economic evaluation.…”

Economic Evaluation of Health Interventions: A Critical Review

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies ( 8 , 14 ).…”

“…Other outcome measures were saved money (40%), QALY (27%), prevented DALYs, and increased quality of life. This finding is consistent with the results of other studies (8,14). Experimental and quasi-experimental studies were mainly used for the economic evaluation of health interventions.…”

Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries

“…In this current review, the majority of reviewed studies (47%) were poor and extremely poor quality and only 18% were good quality and 6% were excellent quality. These findings are in line with the results of research by Walker and Fox-Rushby 71 and Lee et al, 67 who also found a limited supply of good quality economic evaluation studies in developing countries. Based on the small number of publications found, it appears that health policies and plans in G.C.C are being made without sound economic evaluation data, which confirms findings by Maynard.…”

The state of health economics and pharmaceoconomics research in Russia: a systematic review

“…This may be explained by the fact that few Russian researchers are proficient in English to be able to publish independently in international journals or to collaborate with their foreign colleagues. There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium‐ and low‐income countries [52,53] . The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings [6,8,44] .…”

“…There is possibility that this finding may indicate that there is a paucity of economic evaluation data pertaining to treatments in Russia as in other medium-and low-income countries. [52,53] The limited number of evaluations of costs and benefits of treatments available in Russia (in the English language) corroborates previous findings. [6,8,44] There are several factors that may explain the limited number of health economic studies, including economic evaluations, in Russia including organisation and payment structure of the healthcare system, and limited expertise in economic evaluation.…”