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Estimating System-Wide Healthcare Costs Using a Health System Model: Application to the Thanzi La Onse Model of Malawi. 使用卫生系统模型估算全系统医疗保健成本:在马拉维Thanzi La Onse模型中的应用。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-05-03 DOI: 10.1007/s40258-026-01030-w
Sakshi Mohan, Newton Chagoma, Simon Walker, Christian Abraham Arega, Martin Chalkley, Joseph Collins, Emilia Connolly, Tim Colbourn, Eva Janoušková, Tara D Mangal, Gerald Manthalu, Joseph Mfutso-Bengo, Margherita Molaro, Dominic Nkhoma, Andrew Phillips, Lalit Sharma, Bingling She, Wiktoria Tafesse, Pakwanja Desiree Twea, Paul Revill, Timothy B Hallett
{"title":"Estimating System-Wide Healthcare Costs Using a Health System Model: Application to the Thanzi La Onse Model of Malawi.","authors":"Sakshi Mohan, Newton Chagoma, Simon Walker, Christian Abraham Arega, Martin Chalkley, Joseph Collins, Emilia Connolly, Tim Colbourn, Eva Janoušková, Tara D Mangal, Gerald Manthalu, Joseph Mfutso-Bengo, Margherita Molaro, Dominic Nkhoma, Andrew Phillips, Lalit Sharma, Bingling She, Wiktoria Tafesse, Pakwanja Desiree Twea, Paul Revill, Timothy B Hallett","doi":"10.1007/s40258-026-01030-w","DOIUrl":"https://doi.org/10.1007/s40258-026-01030-w","url":null,"abstract":"<p><strong>Objectives: </strong>Modelling approaches that consider system-wide delivery platforms rather than single diseases can be instrumental in economic evaluation and forward-looking policy formulation. This study develops a costing approach tailored to the Thanzi La Onse (TLO) model of Malawi's healthcare system, with general applicability to other health system models.</p><p><strong>Methods: </strong>We developed a mixed-method costing approach to estimate the total cost of healthcare delivery (excluding high-level administrative costs) in Malawi using the TLO model, from a healthcare provider perspective. Through iterative adjustments of key parameters, we aligned model-based estimates as closely as possible with real-world expenditure and budget data. Costs were projected for 2023-2030 under alternative scenarios of health system capacity.</p><p><strong>Results: </strong>A comparison with expenditure and budget data suggests our costing method is broadly reliable for the conditions captured by the model, though some mismatches remain owing to data limitations and definitional inconsistencies. Under current system capacity, total healthcare delivery costs for 2023-2030 were estimated at 2.83 billion US dollars [95% uncertainty interval (UI), $2.80-$2.87 billion], excluding non-medical infrastructure and administrative costs, averaging $390.98 million [$385.92-$396.71 million] annually or $16.89 [$16.75-$17.08] per capita. Scenario analysis highlighted strong interdependencies within the health system. Improving consumable availability alone increased consumables costs by 4.63%, while expanding human resources for health (HRH) alone increased them by 1.43%. When both HRH and consumable availability were expanded together, consumable costs rose by 5.93%, a combined effect larger than either change alone, illustrating how bottlenecks in one component constrain the impact of improvements in another.</p><p><strong>Conclusions: </strong>Mixed-method costing using health system models is a feasible and robust method to estimate and forecast healthcare delivery costs. Clarifying assumptions and limitations can improve their utility for economic analyses and evidence-based planning in the health sector.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost Effectiveness of Endovascular Thrombectomy for Large Ischemic Strokes: A US Healthcare Payer Markov Model Informed by Randomized Trials. 血管内血栓切除术治疗大面积缺血性中风的成本效益:美国医疗保健支付者马尔可夫模型随机试验
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-04-18 DOI: 10.1007/s40258-026-01045-3
Rami Z Morsi, Yuan Zhang, Elena Badillo Goicoechea, Harsh Desai, Sachin A Kothari, Sonam Thind, Archit B Baskaran, Ahmad Chahine, James E Siegler, Elisheva R Coleman, James R Brorson, Ali Mansour, Shyam Prabhakaran, Tareq Kass-Hout
{"title":"Cost Effectiveness of Endovascular Thrombectomy for Large Ischemic Strokes: A US Healthcare Payer Markov Model Informed by Randomized Trials.","authors":"Rami Z Morsi, Yuan Zhang, Elena Badillo Goicoechea, Harsh Desai, Sachin A Kothari, Sonam Thind, Archit B Baskaran, Ahmad Chahine, James E Siegler, Elisheva R Coleman, James R Brorson, Ali Mansour, Shyam Prabhakaran, Tareq Kass-Hout","doi":"10.1007/s40258-026-01045-3","DOIUrl":"https://doi.org/10.1007/s40258-026-01045-3","url":null,"abstract":"<p><strong>Background and objective: </strong>Endovascular thrombectomy is standard for acute large-vessel occlusion stroke, but the value of endovascular thrombectomy in patients with large ischemic regions remains uncertain from a US healthcare payer perspective. This study evaluated the cost effectiveness of endovascular thrombectomy plus medical management (MM) versus MM alone in patients with large ischemic regions, synthesizing data from a recent meta-analysis of all available randomized trials.</p><p><strong>Methods: </strong>We developed a decision tree linked to a Markov model to perform a cost-utility analysis of endovascular thrombectomy plus MM versus MM alone from a US healthcare payer perspective over 90-day, 1-year, 5-year, and 20-year horizons. The target population was adults with acute ischemic stroke from large-vessel occlusion and Alberta Stroke Program Early CT Score (ASPECTS) < 6 or infarct core volume ≥ 50 mL. Clinical inputs came from a systematic review of randomized trials. The primary outcome was the incremental cost-effectiveness ratio, expressed as cost per quality-adjusted life-year (QALY) gained. Scenario analyses (90-day, 1-year, 5-year, and 20-year horizons) and sensitivity analyses evaluated uncertainty.</p><p><strong>Results: </strong>Over 20 years, endovascular thrombectomy plus MM yielded 0.44 additional QALYs and US dollars 19,611 higher costs versus MM alone, with an incremental cost-effectiveness ratio of US dollars 45,117 per QALY. Endovascular thrombectomy plus MM was cost effective in 59.4% and 94.3% of simulations at willingness-to-pay thresholds of US dollars 50,000 and 100,000 per QALY, respectively, whereas MM alone was dominant over a 90‑day horizon.</p><p><strong>Conclusions: </strong>From a US healthcare payer perspective, endovascular thrombectomy for large ischemic strokes is unlikely to be cost effective in the short term but becomes more likely to be cost effective over a 20-year time horizon at commonly used willingness-to-pay thresholds, highlighting the importance of adopting long‑term perspectives in coverage and reimbursement decisions.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Costs and Budget Impact of a Health System Strengthening Intervention for Hypertension and Cardiovascular Disease Care in Ghana. 加纳加强高血压和心血管疾病护理卫生系统干预的成本和预算影响。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-04-15 DOI: 10.1007/s40258-026-01043-5
Kavita Singh, Eugene Kallson, Elom Hillary Otchi, Rupal Shah-Rohlfs, Juliette Selom Edzeame, Fionn Harnischfeger, Alfred Edwin Yawson, Manuela De Allegri
{"title":"Costs and Budget Impact of a Health System Strengthening Intervention for Hypertension and Cardiovascular Disease Care in Ghana.","authors":"Kavita Singh, Eugene Kallson, Elom Hillary Otchi, Rupal Shah-Rohlfs, Juliette Selom Edzeame, Fionn Harnischfeger, Alfred Edwin Yawson, Manuela De Allegri","doi":"10.1007/s40258-026-01043-5","DOIUrl":"https://doi.org/10.1007/s40258-026-01043-5","url":null,"abstract":"<p><strong>Objectives: </strong> Cardiovascular diseases (CVDs) are a leading contributor to morbidity, mortality, and healthcare spending in low- and middle-income countries (LMICs). Despite this burden, economic evidence on system-level interventions to strengthen hypertension and CVD care in sub-Saharan Africa remains limited. This study estimates the costs and budget impact of the Ghana Heart Initiative (GHI), a multi-component health systems strengthening intervention.</p><p><strong>Methods: </strong> We conducted a retrospective cost analysis from the health system perspective using an activity-based costing approach. We estimated the financial and economic costs incurred during the design (2018-2019) and initial implementation phase (2020-2022) of the GHI across 42 public health facilities in the Greater Accra Region. Costs were disaggregated by activity cluster and input category. We then projected the budget impact of hypothetical national scale-up under three implementation scenarios that varied in scope and cost-sharing assumptions. All costs were inflation-adjusted and reported in 2024 US dollars (US $).</p><p><strong>Results: </strong> The total economic cost of designing and implementing the GHI over 4 years was US$1.96 million, of which 91.5% was attributable to implementation activities. Human resources were the primary cost driver. Average annual economic costs were US$11,960 per health facility, US$997 per targeted health provider trained, and US$39.9 per outpatient attendee. Projected annual costs for nationwide scale-up ranged from US$12.1 million to US$30.1 million, depending on implementation scenario, with a streamlined service-delivery-only model representing a lower-bound estimate.</p><p><strong>Conclusions: </strong> This study provides granular, activity-level cost estimates for a complex health system strengthening intervention targeting hypertension and CVD care. The findings offer policy-relevant inputs for budget planning and highlight how implementation choices influence the fiscal implications of scaling up system-level CVD interventions in LMICs.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality-Adjusted Life Expectancy and Cost-Effectiveness Thresholds in Three High-Income Regions in Asia. 亚洲三个高收入地区的质量调整预期寿命和成本效益阈值。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-04-11 DOI: 10.1007/s40258-026-01044-4
Xinyu Zhao, Yawen Jiang
{"title":"Quality-Adjusted Life Expectancy and Cost-Effectiveness Thresholds in Three High-Income Regions in Asia.","authors":"Xinyu Zhao, Yawen Jiang","doi":"10.1007/s40258-026-01044-4","DOIUrl":"https://doi.org/10.1007/s40258-026-01044-4","url":null,"abstract":"<p><strong>Background and objective: </strong>Cost-effectiveness thresholds (CETs) are essential for health technology assessments and resource allocation in healthcare. However, empirical CET estimates alongside quality-adjusted life expectancy are absent for the Hong Kong Special Administrative Region of China (Hong Kong SAR), Taiwan Province of China (Taiwan Province), and Singapore. This study aims to estimate quality-adjusted life expectancy and derive CETs in these regions.</p><p><strong>Methods: </strong>Quality-adjusted life expectancy was calculated by using the Sullivan method. The CET was estimated using the value of a statistical life-based method, adjusted for age-specific life expectancy and health utilities to derive value of a statistical quality-adjusted life-year. Population-weighted value of a statistical quality-adjusted life-year values yielded regional CETs. Final estimates were corrected for overestimation, and sensitivity analyses were conducted.</p><p><strong>Results: </strong>Quality-adjusted life expectancy estimates at birth were 79.98, 76.73, and 79.48 quality-adjusted life-years for Hong Kong SAR, Taiwan Province, and Singapore, respectively. Base-case CETs, expressed as times of gross domestic product per capita, were 3.12 (95% confidence interval 2.38-3.88), 2.15 (95% confidence interval 0.85-3.37), and 3.30 (95% confidence interval 1.77-4.74) for the three regions, respectively. Sensitivity analyses showed CET ranges of 2.86-3.46 (Hong Kong SAR), 2.00-2.39 (Taiwan Province), and 3.07-3.66 (Singapore) times of gross domestic product per capita for utility variations, and 2.02-3.98 (Hong Kong SAR), 1.43-2.71 (Taiwan Province), and 2.11-4.23 (Singapore) times of gross domestic product per capita for discount rate changes.</p><p><strong>Conclusions: </strong>This study provides the first value of a statistical life-based CET estimates integrated with quality-adjusted life expectancy for three high-income regions in Asia. Focusing on context-specific thresholds beyond the World Health Organization benchmarks, the current findings offer a scientific basis for health technology assessments and policy decisions.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lost in Translation? A Scoping Review to Explore the Translation and Cultural Adaptation of Preference-Based Measures of Quality of Life. 迷失在翻译中?基于偏好的生活质量衡量标准的翻译与文化适应研究综述。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-04-07 DOI: 10.1007/s40258-026-01042-6
Jenny Cleland, Kiri Lay, Julie Ratcliffe, Jyoti Khadka
{"title":"Lost in Translation? A Scoping Review to Explore the Translation and Cultural Adaptation of Preference-Based Measures of Quality of Life.","authors":"Jenny Cleland, Kiri Lay, Julie Ratcliffe, Jyoti Khadka","doi":"10.1007/s40258-026-01042-6","DOIUrl":"https://doi.org/10.1007/s40258-026-01042-6","url":null,"abstract":"<p><strong>Background: </strong>Preference-based measures (PBMs) of quality of life are an important tool to inform the evaluation of health and social care interventions and services. Traditionally, PBMs have tended to be developed in a single country, therefore, reflecting the linguistic and cultural norms of that country. Given increases in the cultural and linguistic diversity of populations in many countries, it is important that PBMs are culturally and linguistically adapted. Linguistic adaptation ensures the translated words are correct and accurate, whilst cultural adaptation ensures the meaning and relevance of the concepts are understood as intended by the target audience. Several different guidelines for translation and cultural adaptation exist, including the guidelines developed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).</p><p><strong>Objective: </strong>The aim of this scoping review was to outline which PBMs have been translated and/or culturally adapted and specify any guidelines that have been followed.</p><p><strong>Methods: </strong>Four databases (PubMed, SCOPUS, Web of Science, CINAHL) were searched (February 2025) along with grey literature to identify studies that had translated and/or culturally adapted PBMs.</p><p><strong>Results: </strong>Forty-seven articles were included in the review. Translations of PBMs were common, but there was typically limited information about whether PBMs had been culturally adapted. The studies varied significantly as to whether guidelines had been followed and what steps were taken in the process.</p><p><strong>Conclusion: </strong>This review highlights the variable transparency and inconsistency in the methods adopted for the translation and cultural adaptation of PBMs. The application of standardised translation and cultural adaptation guidelines, such as the ones developed by ISPOR, would enhance the methodological quality and cultural validity of PBMs.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Towards Environmentally Extended Health Economic Analysis Plans: A Case Study for the MEL-SELF Trial. 迈向环境延伸健康经济分析计划:MEL-SELF试验的个案研究。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-04-06 DOI: 10.1007/s40258-026-01041-7
Jake T W Williams, Katy J L Bell, Scott McAlister, Rachael L Morton
{"title":"Towards Environmentally Extended Health Economic Analysis Plans: A Case Study for the MEL-SELF Trial.","authors":"Jake T W Williams, Katy J L Bell, Scott McAlister, Rachael L Morton","doi":"10.1007/s40258-026-01041-7","DOIUrl":"https://doi.org/10.1007/s40258-026-01041-7","url":null,"abstract":"","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Agreement in Qualitative and Quantitative Assessments of Disease Severity: Evidence from Pharmaceutical Reimbursement in Sweden. 疾病严重程度定性和定量评估的一致性:来自瑞典药品报销的证据。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-03-31 DOI: 10.1007/s40258-026-01040-8
Martin Henriksson, Lars Sandman, Jonathan Siverskog
{"title":"Agreement in Qualitative and Quantitative Assessments of Disease Severity: Evidence from Pharmaceutical Reimbursement in Sweden.","authors":"Martin Henriksson, Lars Sandman, Jonathan Siverskog","doi":"10.1007/s40258-026-01040-8","DOIUrl":"https://doi.org/10.1007/s40258-026-01040-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Publicly funded healthcare systems that consider a trade-off between efficiency and equity by allowing a higher cost per patient benefit in patients with more severe conditions must somehow assess disease severity. Some countries employ quantitative measures of shortfall, whereas others rely on qualitative assessments. Despite its importance in pharmaceutical reimbursement and pricing, the operationalisation of disease severity in real-world decision making has rarely been scrutinized. The aim of this study was to investigate the relationship and agreement between qualitative disease severity assessments and quantitative measures of disease severity in Swedish pharmaceutical reimbursement.</p><p><strong>Methods: </strong>Information from 36 pharmaceutical reimbursement decisions made by the Dental and Pharmaceutical Benefits Agency (TLV) in Sweden from 2018 to 2023 was extracted, including the qualitative assessment of disease severity (moderate, high, or very high). Based on publicly available decision documents from the agency, we calculated absolute QALY shortfall (AS) and proportional QALY shortfall (PS). Linear regression was used to describe the mean shortfall across severity classifications. Ordinal logistic regression was used to analyse the role of AS and PS as predictors of TLV's qualitative disease-severity assessments and the predictive ability of both measures was compared using the coefficient of discrimination (D').</p><p><strong>Results: </strong>The mean AS and PS was 12.2 and 0.796, respectively, in the very high disease severity category, which was approximately twice the mean shortfall observed in the moderate and high severity categories (Moderate: AS = 6.0, PS = 0.340; High: AS = 6.2, PS = 0.405). When the quantitative measures of severity were used as predictors of the qualitative assessments, PS was better able to discriminate between TLV's severity classifications than was AS (D' = 34.6% vs 22.3%). However, both measures frequently predicted low probabilities of the qualitative assessments that were observed and there was both substantial variation in shortfall for diseases with the same qualitative assessment (AS, R<sup>2</sup> = 35.8%; PS, R<sup>2</sup> = 61.0%) and overlaps in observed shortfall across different severity classifications.</p><p><strong>Conclusion: </strong>Proportional QALY shortfall agrees more closely than AS with qualitatively assessed disease severity applied in the Swedish reimbursement system but there are large variations in the qualitative assessments that cannot be explained by either measure. Further investigation is warranted to understand if this is an intended and desired outcome.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Economic Value of Non-pharmaceutical Interventions for Influenza and COVID-19: A Systematic Review. 流感和COVID-19非药物干预措施的经济价值:系统评价
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-03-25 DOI: 10.1007/s40258-026-01039-1
Hui Yee Yeo, Trinh Manh Hung, Nhung Nghiem, Steffen Albrecht, Nikki Turner, Peter McIntyre
{"title":"The Economic Value of Non-pharmaceutical Interventions for Influenza and COVID-19: A Systematic Review.","authors":"Hui Yee Yeo, Trinh Manh Hung, Nhung Nghiem, Steffen Albrecht, Nikki Turner, Peter McIntyre","doi":"10.1007/s40258-026-01039-1","DOIUrl":"https://doi.org/10.1007/s40258-026-01039-1","url":null,"abstract":"<p><strong>Background: </strong>Non-pharmaceutical interventions (NPIs) are central to mitigating COVID-19 and influenza, yet comparative economic evaluations remain scarce. This systematic review assessed the cost effectiveness and reporting quality of NPI evaluations across both diseases. The study was registered with PROSPERO (CRD42024552613).</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, we searched five medical (PubMed, Scopus, EMBASE, CINAHL, and EconLit) and four health technology assessment databases (NHS HTA, CRD DARE, NHS EED, and INAHTA) up to December 2025, including only full economic evaluations. The search strategy incorporated four domains-'influenza,' 'COVID-19,' 'NPIs,' and 'economic evaluation'-and was guided by the WHO NPI framework, encompassing five domains: personal protective, environmental, physical distancing, travel-related, and educational measures. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) checklist.</p><p><strong>Results: </strong>Thirty-three studies (13 influenza, 20 COVID-19), predominantly from high-income countries, were included. School closures, the most frequently evaluated NPI, were generally not cost effective except during severe pandemics or bundled with other measures. Workforce and business closures were cost effective only in high-severity influenza, with inconsistent findings for COVID-19. Social distancing was cost effective for COVID-19 but not for H1N1 influenza. Isolation, lockdowns, and travel restrictions were cost effective only when implemented early. Face masks and hand hygiene, assessed solely for COVID-19, were generally cost effective when implemented alongside other measures. The median CHEERS score was 75.0%, with one study rated excellent.</p><p><strong>Conclusion: </strong>Our review highlights heterogeneity in cost effectiveness by pandemic severity, intervention type, bundling of measures, and timing. Strategies that combined low-cost NPIs like masks or hand hygiene demonstrated better value, while socially disruptive measures like school and business closure incurred high costs with inconsistent cost-effectiveness outcomes. Integration with vaccines or antivirals further enhanced cost effectiveness. Evidence gaps include the scarcity of evaluations from low-resource settings and variability in country-specific value thresholds. Addressing these gaps is essential for guiding efficient and cost-effective pandemic preparedness.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Systematic Review of Microsimulation Models in Cardiometabolic Disease: Model Calibration and Validation 心血管代谢疾病微模拟模型的系统综述:模型校准和验证。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-03-25 DOI: 10.1007/s40258-026-01036-4
Danwei Yang, Zhixin Cao, Jayoung Byun, Jong-Wook Ban, David D. Kim
{"title":"A Systematic Review of Microsimulation Models in Cardiometabolic Disease: Model Calibration and Validation","authors":"Danwei Yang,&nbsp;Zhixin Cao,&nbsp;Jayoung Byun,&nbsp;Jong-Wook Ban,&nbsp;David D. Kim","doi":"10.1007/s40258-026-01036-4","DOIUrl":"10.1007/s40258-026-01036-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Microsimulation models are increasingly used to project health trajectories of individuals with cardiometabolic diseases, including type 2 diabetes, obesity, cardiovascular disease, and chronic kidney disease. Despite the emergence of practice guidelines on model calibration and validation, it remains unclear whether practices in model development and reporting have improved accordingly.&lt;/p&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;To summarize the characteristics of studies reporting cardiometabolic disease microsimulation models, assess how calibration and validation processes are reported, and examine variations in reporting practices by study characteristics.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We searched PubMed, Embase, and Web of Science for studies reporting the original development of microsimulation models of cardiometabolic diseases published between 2016 and June 1, 2024. Studies reporting calibration and/or validation processes were included. We recorded study characteristics and assessed reporting adherence to six calibration processes (defining parameters, selecting targets, applying search strategies, specifying convergence criteria, establishing stopping rules, and selecting goodness-of-fit measures) and five validation processes (face validity, verification, cross-validation, external validation, and predictive validation) based on published practice guidelines. We further investigated variation in guideline adherence by study characteristics (modeling type, cardiometabolic diseases, publication year, baseline population data source, modeling country, simulation tool, and open-source status). This study is registered in PROSPERO (CRD42024562800).&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Of 2646 studies screened, 31 were included in the final sample. Sixteen studies (52%) reported application-based model development and 15 (48%) reported natural history model development; 7 (23%) made their code publicly available; and 8 (26%) simulated three or more diseases. For calibration, 23 studies (74%) reported at least one of the six processes, most often specifying calibration targets (&lt;i&gt;n&lt;/i&gt; = 22, 71%) and calibrated parameters (&lt;i&gt;n =&lt;/i&gt; 21, 68%). For validation, 26 studies (84%) reported at least one of the five processes, most commonly external validation (&lt;i&gt;n =&lt;/i&gt; 19, 61%), but no study reported predictive validation. Studies that developed natural history models more often reported goodness-of-fit measures, stopping rules, and external validation than application-based models. Studies that open-sourced their code reported statistical goodness-of-fit measures more frequently than those that did not. Models simulating three or more diseases more often documented face validity and verification than those simulating fewer diseases.&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Reporting of calibration and validation in recent microsimulation models has improved, but important gaps remain. We suggest that future work prioritize (1) more rigorous calibration and validation in ","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"24 3","pages":"459 - 478"},"PeriodicalIF":3.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-026-01036-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insights from Patient and Public Involvement (PPI) in Economic Evaluations of Severe Mental Illness: Comparing Recovering Quality of Life (ReQoL) and the EQ-5D-5L. 重度精神疾病经济评价中患者和公众参与(PPI)的启示:比较康复生活质量(ReQoL)和EQ-5D-5L。
IF 3.3 4区 医学
Applied Health Economics and Health Policy Pub Date : 2026-03-23 DOI: 10.1007/s40258-026-01038-2
Gemma Shields, Cheyann J Heap, Raj Hazzard, Rebekah Carney
{"title":"Insights from Patient and Public Involvement (PPI) in Economic Evaluations of Severe Mental Illness: Comparing Recovering Quality of Life (ReQoL) and the EQ-5D-5L.","authors":"Gemma Shields, Cheyann J Heap, Raj Hazzard, Rebekah Carney","doi":"10.1007/s40258-026-01038-2","DOIUrl":"10.1007/s40258-026-01038-2","url":null,"abstract":"","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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