title: Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.
abstract: Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.
authors.affiliation: Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.
authors.forename: Benjarin
authors.initials: B
authors.lastname: Santatiwongchai
authors.affiliation: Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.
authors.forename: Varit
authors.initials: V
authors.lastname: Chantarastapornchit
authors.affiliation: NICE International, National Institute for Health and Care Excellence, London, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wilkinson
authors.affiliation: Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.
authors.forename: Kittiphong
authors.initials: K
authors.lastname: Thiboonboon
authors.affiliation: Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.
authors.forename: Waranya
authors.initials: W
authors.lastname: Rattanavipapong
authors.affiliation: Global Health Program, Bill and Melinda Gates Foundation, Seattle, Washington, United States of America.
authors.forename: Damian G
authors.initials: DG
authors.lastname: Walker
authors.affiliation: NICE International, National Institute for Health and Care Excellence, London, United Kingdom.
authors.forename: Kalipso
authors.initials: K
authors.lastname: Chalkidou
authors.affiliation: Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.
authors.forename: Yot
authors.initials: Y
authors.lastname: Teerawattananon
mesh_terms: D003365:Costs and Cost Analysis / Q000592:standards*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D015658:HIV Infections / Q000191:economics; D006801:Humans; D008288:Malaria / Q000191:economics; D017059:Models, Econometric; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000191:economics; D014612:Vaccines / Q000191:economics
chemical_list: D014612:Vaccines