A Systematic Review of Economic Evaluation Methodologies Between Resource-Limited and Resource-Rich Countries: A Case of Rotavirus Vaccines

Thiboonboon, Kittiphong; Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Rattanavipapong, Waranya; Teerawattananon, Yot

doi:10.1007/s40258-016-0265-y

Cited by 13 publications

(14 citation statements)

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“…Findings in many studies have further indicated that the issues on availability and quality of data used in the economic evaluation as well as relevant research standards are significant in LMICs [ 5 , 6 , 8 ]. Although some data, such as treatment effect, is considered transferable across settings [ 9 ] (and therefore researchers may choose to borrow from other contexts), application of this approach to other types of inputs that are more context-specific (e.g.…”

Section: Introductionmentioning

confidence: 99%

Identifying priority technical and context-specific issues in improving the conduct, reporting and use of health economic evaluation in low- and middle-income countries

Luz¹,

Santatiwongchai²,

Pattanaphesaj³

et al. 2018

Health Res Policy Sys

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BackgroundThe use of economic evaluation in healthcare policies and decision-making, which is limited in low- and middle-income countries (LMICs), might be promoted through the improvement of the conduct and reporting of studies. Although the literature indicates that there are many issues affecting the conduct, reporting and use of this evidence, it is unclear which factors should be prioritised in finding solutions. This study aims to identify the top priority issues that impede the conduct, reporting and use of economic evaluation as well as potential solutions as an input for future research topics by the international Decision Support Initiative and other movements.MethodsA survey on issues regarding the conduct, reporting and use of economic evaluation as well as on potential solutions was conducted using an online questionnaire among researchers who have experience in conducting economic evaluations in LMICs. The respondents were requested to consider the list of issues provided, rank the most important ones and propose solutions. A scoring system was applied to derive the ranking of difficulties according to researchers’ responses. Issues were grouped into technical and context-specific difficulties and analysed separately as a whole and by region.ResultsResearchers considered the lack of quality local clinical data, poor reporting and insufficient data to conduct the analysis from the chosen perspective as the most important technical difficulties. On the other hand, the non-integration of economic evaluations into decision-making was considered the most important context-specific issue. Finally, context-specific issues were considered the larger barrier to the use of economic evaluation.ConclusionThe technical issues that were considered most important were closely linked with the lack of an appropriately functioning information system as well as the capacity to generate essential contextual information (e.g. data and locally relevant utility values), especially when the methodology is complex. To overcome this, simpler approaches to collect data that yields information of comparable quality to more rigorous methods should be developed. The international community can play a major role through research on methodologies feasible for LMIC settings as well as in building research capacity in countries. Context-specific issues, which were recognised as larger barriers, should be improved in parallel.Electronic supplementary materialThe online version of this article (10.1186/s12961-018-0280-6) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Identifying priority technical and context-specific issues in improving the conduct, reporting and use of health economic evaluation in low- and middle-income countries

Luz¹,

Santatiwongchai²,

Pattanaphesaj³

et al. 2018

Health Res Policy Sys

Self Cite

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“…However, those contemplating such implementation should consider not only the vaccine’s clinical effectiveness but also its cost-effectiveness, which is particularly important in LICs and LMICs. Nevertheless, economic evaluations of rotavirus vaccine are still limited in LICs and LMICs owing to lack of both local cost and clinical effectiveness data and the research capacity to conduct such evaluations [3, 10, 11]. Therefore, systematic reviews of published economic evaluations of rotavirus vaccine could be used as the evidence to guide decisions about vaccine policy.…”

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confidence: 99%

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confidence: 99%

“…Many individual studies have been conducted across the world to assess the cost-effectiveness of rotavirus vaccines, and these individual evidences have been summarized in 2 systematic reviews [3, 11]. However, the systematic review by Thiboonboon et al [11] mainly focused on methodological differences between economic studies conducted in high-income countries (HIC) and in LMICs, whereas the systematic review by Kotirum et al [3] provided only qualitative evidence without distinguishing LICs and LMICs. Neither review provided quantitative evidence of cost-effectiveness measured by the incremental cost-effectiveness ratio (ICER), the ratio of the cost difference between new and standard treatments to the clinical effectiveness difference between these treatments [12], which can be more useful for policy makers in LICs and LMICs.…”

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confidence: 99%

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Systematic Review and Meta-Analysis of Cost-effectiveness of Rotavirus Vaccine in Low-Income and Lower-Middle-Income Countries

Haider

Chaikledkaew

Thavorncharoensap

et al. 2019

Open Forum Infectious Diseases

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Background Rotavirus causes morbidity and mortality in children particularly in low-income countries (LICs) and lower-middle-income countries (LMICs). This systematic review and meta-analysis aimed to assess cost-effectiveness of rotavirus vaccine in LICs and LMICs. Methods Relevant studies were identified from PubMed and Scopus from their inception to January 2019. Studies were eligible if they assessed the cost-effectiveness of rotavirus vaccine in children in LICs and LMICs and reported incremental cost-effectiveness ratios. Risk of bias and quality assessment was assessed based on the Consolidated Health Economic Evaluation Reporting Standard checklist. Incremental net benefits (INBs) were estimated, and meta-analysis based on the DerSimonian and Laird method was applied to pool INBs across studies. Results We identified 1614 studies, of which 28 studies (29 countries) were eligible and conducted using cost-utility analysis in LICs (n = 8) and LMICs (n = 21). The pooled INB was estimated at $62.17 (95% confidence interval, $7.12–$117.21) in LICs, with a highly significant heterogeneity (χ 2 = 33.96; df = 6; P < .001; I 2 = 82.3%), whereas the pooled INB in LMICs was $82.46 (95% confidence interval, $54.52–$110.41) with no heterogeneity (χ 2 = 8.46; df = 11; P = .67; I 2 = 0%). Conclusions Rotavirus vaccine would be cost-effective to introduce in LICs and LMICs. These findings could aid decision makers and provide evidence for introduction of rotavirus vaccination.

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“…We also carried out searches of the first 150 hits in Google and Google Scholar using BIA-specific search terms to identify any unpublished BIAs (Online Resource 1 of the ESM). We supplemented the database searches by conducting manual bibliographic searches from recent and relevant rotavirus vaccine review papers [ 14 , 15 , 29 , 33 – 35 ].…”

Section: Methodsmentioning

confidence: 99%

Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework

et al. 2017

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BackgroundIn low- and middle-income countries, budget impact is an important criterion for funding new interventions, particularly for large public health investments such as new vaccines. However, budget impact analyses remain less frequently conducted and less well researched than cost-effectiveness analyses.ObjectiveThe objective of this study was to fill the gap in research on budget impact analyses by assessing (1) the quality of stand-alone budget impact analyses, and (2) the feasibility of extending cost-effectiveness analyses to capture budget impact.MethodsWe developed a budget impact analysis checklist and scoring system for budget impact analyses, which we then adapted for cost-effectiveness analyses, based on current International Society for Pharmacoeconomics and Outcomes Research Task Force recommendations. We applied both budget impact analysis and cost-effectiveness analysis checklists and scoring systems to examine the extent to which existing economic evaluations provide sufficient evidence about budget impact to enable decision making. We used rotavirus vaccination as an illustrative case in which low- and middle-income countries uptake has been limited despite demonstrated cost effectiveness. A systematic literature review was conducted to identify economic evaluations of rotavirus vaccine in low- and middle-income countries published between January 2000 and February 2017. We critically appraised the quality of budget impact analyses, and assessed the extension of cost-effectiveness analyses to provide useful budget impact information.ResultsSix budget impact analyses and 60 cost-effectiveness analyses were identified. Budget impact analyses adhered to most International Society for Pharmacoeconomics and Outcomes Research recommendations, with key exceptions being provision of undiscounted financial streams for each budget period and model validation. Most cost-effectiveness analyses could not be extended to provide useful budget impact information; cost-effectiveness analyses also rarely presented undiscounted annual costs, or estimated financial streams during the first years of programme scale-up.ConclusionsCost-effectiveness analyses vastly outnumber budget impact analyses of rotavirus vaccination, despite both being critical for policy decision making. Straightforward changes to the presentation of cost-effectiveness analyses results could facilitate their adaptation into budget impact analyses.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-017-0569-2) contains supplementary material, which is available to authorized users.

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A Systematic Review of Economic Evaluation Methodologies Between Resource-Limited and Resource-Rich Countries: A Case of Rotavirus Vaccines

Cited by 13 publications

References 34 publications

Identifying priority technical and context-specific issues in improving the conduct, reporting and use of health economic evaluation in low- and middle-income countries

Identifying priority technical and context-specific issues in improving the conduct, reporting and use of health economic evaluation in low- and middle-income countries

Systematic Review and Meta-Analysis of Cost-effectiveness of Rotavirus Vaccine in Low-Income and Lower-Middle-Income Countries

Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework

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