Estimating Cost Functions for Resource Allocation Using Transmission Models: A Case Study of Tuberculosis Case Finding in South Africa

Abstract

Highlights• Mathematical and economic modelling is being used to inform how disease control resources are allocated and what policies are adopted. These models specify complex non-linear relationships between service coverage and impact. However, functions describing the relationship between costs and service volume have typically been less sophisticated, assuming constant marginal costs of expanding service coverage. This approach runs counter to the theoretical understanding of the way costs behave when scaling up.• We propose an alternative approach. We developed a mechanistic framework to estimate total costs for inclusion in model-based economic evaluations using a combination of secondary data from small-scale costing studies and routine reporting systems. We provide a pragmatic, mechanistic framework rooted in economic theory for others facing similar data constraints to improve resource allocation models used to define packages of interventions within LMIC settings.• Using a case study of tuberculosis case detection in South Africa, we show that the functional form chosen to estimate total costs will determine the magnitude of total costs when increasing the outputs and coverage. In turn, these differences can impact policy choice and resource allocation decisions. The framework presented here is a first step towards a more transparent and empirically based cost modelling approach to better inform resource allocation processes.

Using system dynamics modelling to estimate the costs of relaxing health system constraints: a case study of tuberculosis prevention and control interventions in South Africa

“…An example would be the costs of enhancing routine staff training and supervision, which are shared by all the interventions analysed with the exception of building retrofits. Similarly, gains in efficiency could be realized from scaling up the interventions to the regional and/or national level ( Gomez et al. , 2020 ).…”

Avaliação econômica por receita tarifária das empresas metroferroviárias brasileiras

“…Ampliando a pesquisa realizada, identifica-se que há ganhos de escala em setores como Educação, Seguros, Telecomunicação e Saúde, sendo a estimação desses ganhos feita por meio de funções de custos, como nos estudos de Agasisti e Jhones (2016), Klotzki et al (2018), Vendrúsculo e Alves (2009), Gomez et al (2020) e Chattopadhyay (2021). Embora esses segmentos sejam distintos do que se aborda neste estudo, o procedimento para detecção de ganhos de ocupação da escala foi o mesmo, ou seja, via funções de custos.…”

A two-stage UAV routing problem with time window considering rescheduling with random delivery reliability

“…The costs of unvisited targets are difficult to measure in practice. Therefore, this paper refers to the mechanistic mathematical framework of Gomez et al [30] which is based on the economic evaluations and the actual situation to present the costs parameters directly.…”