An implicit price of a DALY for use in a cost-benefit analysis of ARVs

Brent, Robert J.

doi:10.1080/00036840802600475

Cited by 22 publications

(25 citation statements)

References 14 publications

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“…In order to express program benefits in the same units as costs, the number of DALYs gained from each program was multiplied by a marginal value of $7,773, before subtracting the total cost of the program to obtain net benefits (which are presented in per capita terms in the results). The figure for the marginal value per DALY saved is obtained from the cost‐effectiveness threshold of three times per GDP per capita recommended by the WHO‐CHOICE project, and also happens to be within the range of marginal values reported in a revealed preference study estimating the value of a quality‐adjusted life year in terms of international global health funding for malaria, tuberculosis, and HIV …”

Section: Methodssupporting

confidence: 60%

“…The calculated impacts include metrics related to malaria burden (e.g., incidence of uncomplicated cases, severe cases, and deaths, which are aggregated into disability‐adjusted life years or DALYs) and program costs. We employ a benefit‐cost metric in which health impacts are computed in terms of disability‐adjusted life years (DALYs) and then monetized using cost‐effectiveness thresholds, in order to compare with program costs . Below we describe the components of the model directly relevant for the analysis in this article, and refer readers to the MDAST user manual and the open‐source model for further details and references…”

Section: Methodsmentioning

confidence: 99%

“…We employ a benefit-cost metric in which health impacts are computed in terms of disabilityadjusted life years (DALYs) and then monetized using cost-effectiveness thresholds, in order to compare with program costs. (11,16) Below we describe the components of the model directly relevant for the analysis in this article, and refer readers to the MDAST user manual and the open-source model for further details and references. (17) Fig.…”

Section: Target Outcomes and Uncertain Parameters In Mdastmentioning

confidence: 99%

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The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

et al. 2016

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Decision analysis tools and mathematical modeling are increasingly emphasized in malaria control programs worldwide, to improve resource allocation and address ongoing challenges with sustainability. However, such tools require substantial scientific evidence, which is costly to acquire. The value of information (VOI) has been proposed as a metric for gauging the value of reduced model uncertainty. We apply this concept to an evidenced-based Malaria Decision Analysis Support Tool (MDAST) designed for application in East Africa. In developing MDAST, substantial gaps in the scientific evidence base were identified regarding insecticide resistance in malaria vector control and the effectiveness of alternative mosquito control approaches, including larviciding. We identify four entomological parameters in the model (two for insecticide resistance and two for larviciding) which involve high levels of uncertainty and to which outputs in MDAST are sensitive. We estimate and compare a VOI for combinations of these parameters in evaluating three policy alternatives relative to a status quo policy. We find having perfect information on the uncertain parameters could improve program net benefits by up to 5%–21%, with the highest VOI associated with jointly eliminating uncertainty about reproductive speed of malaria-transmitting mosquitoes and initial efficacy of larviciding at reducing the emergence of new adult mosquitoes. Future research on parameter uncertainty in decision analysis of malaria control policy should investigate the VOI with respect to other aspects of malaria transmission (such as antimalarial resistance), the costs of reducing uncertainty in these parameters, and the extent to which imperfect information about these parameters can improve payoffs.

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Section: Methodssupporting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Section: Target Outcomes and Uncertain Parameters In Mdastmentioning

confidence: 99%

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The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

et al. 2016

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“…60 The results can be used to estimate the number of DALYs potentially saved through management of introduced mammal populations on a particular island, and then be assigned a monetary value to be compared with the monetary costs of the management action. 61 Management of introduced mammals on inhabited islands implies social, cultural, and economic challenges that should be considered when assessing the feasibility of management actions. 58,62,63 For example, costs of eradication vary greatly, mostly as a function of population size, island area (e.g., US $3 to $20,000 per hectare), the type of eradication method (target species dependent), and other variable costs such as capacity building, environmental compliance, and mitigation of nontarget species.…”

Section: Discussionmentioning

confidence: 99%

“…60 The monetary value of DALYs can be estimated based on the region's income, the funds allocated toward disease alleviation, and the DALY value of the disease. 61 The fitted models above could be used to provide an initial estimate of disease incidence or seroprevalence on islands, island countries, or countries within islands where this information is missing to identify prospective islands in which local data should be collected. Ultimately, these results could be converted into DALYs.…”

Section: Discussionmentioning

confidence: 99%

Estimating Burdens of Neglected Tropical Zoonotic Diseases on Islands with Introduced Mammals

Wit

Croll

Tershy

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. Many neglected tropical zoonotic pathogens are maintained by introduced mammals, and on islands the most common introduced species are rodents, cats, and dogs. Management of introduced mammals, including control or eradication of feral populations, which is frequently done for ecological restoration, could also reduce or eliminate the pathogens these animals carry. Understanding the burden of these zoonotic diseases is crucial for quantifying the potential public health benefits of introduced mammal management. However, epidemiological data are only available from a small subset of islands where these introduced mammals co-occur with people. We examined socioeconomic and climatic variables as predictors for disease burdens of angiostrongyliasis, leptospirosis, toxoplasmosis, toxocariasis, and rabies from 57 islands or island countries. We found strong correlates of disease burden for leptospirosis, Toxoplasma gondii infection, angiostrongyliasis, and toxocariasis with more than 50% of the variance explained, and an average of 57% (range = 32-95%) predictive accuracy on out-of-sample data. We used these relationships to provide estimates of leptospirosis incidence and T. gondii seroprevalence infection on islands where nonnative rodents and cats are present. These predicted estimates of disease burden could be used in an initial assessment of whether the costs of managing introduced mammal reservoirs might be less than the costs of perpetual treatment of these diseases on islands.

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A social cost–benefit criterion for evaluating Voluntary Counseling and Testing with an application to Tanzania

Brent

2009

Health Economics

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We find separate testing in existing VCT programs to be only marginally worthwhile. However, in scaled-up programs the benefit-cost ratio is over three. Dual testing is always more beneficial than separate testing. However, this advantage is reduced in scaled-up programs. VCT should be greatly expanded throughout Tanzania as future returns would be even higher for both separate and joint counseling and HIV testing.

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An implicit price of a DALY for use in a cost-benefit analysis of ARVs

Cited by 22 publications

References 14 publications

The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

Estimating Burdens of Neglected Tropical Zoonotic Diseases on Islands with Introduced Mammals

A social cost–benefit criterion for evaluating Voluntary Counseling and Testing with an application to Tanzania

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