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Costing of measles elimination : report of a WHO meeting, Copenhagen, Denmark, 23-24 October 2000
World Health Organization. Regional Office for Europe ( 2001 )
The costing of primary health care : report of an information consultation organized by the Nucleus of the National Health Development Network, Ethiopia, and the World Health Organization, Nazareth, Ethiopia, 12-16 December 1983
World Health Organization. Division of Strengthening of Health Services; National Health Development Network (Ethiopia); World Health Organization ( 1984 )
Costing RTS,S introduction in Burkina Faso, Ghana, Kenya, Senegal, Tanzania, and Uganda: A generalizable approach drawing on publicly available data
Lauer, Jeremy; Bertram, Melanie; Tediosi, Fabrizio; Galactionova, Katya ( 2015-10-27 )
Abstract

Recent results from the phase 3 trial of RTS,S/AS01 malaria vaccine show that the vaccine induced partial protection against clinical malaria in infants and children; given the high burden of the disease it is currently considered for use in malaria endemic countries. To inform adoption decisions the paper proposes a generalizable methodology to estimate the cost of vaccine introduction using routinely collected and publicly available data from the cMYP, UNICEF, and WHO-CHOICE. Costing is carried out around a set of generic activities, assumptions, and inputs for delivery of immunization services adapted to a given country and deployment modality to capture among other factors the structure of the EPI program, distribution model, geography, and demographics particular to the setting. The methodology is applied to estimate the cost of RTS,S introduction in Burkina Faso, Ghana, Kenya, Senegal, Tanzania, and Uganda. At an assumed vaccine price of $5 per dose and given our assumptions on coverage and deployment strategy, we estimate total economic program costs for a 6-9 months cohort within $23.11-$28.28 per fully vaccinated child across the 6 countries. Net of procurement, costs at country level are substantial; for instance in Tanzania these could add as much as $4.2 million per year or an additional $2.4 per infant depending on the level of spare capacity in the system. Differences in cost of vaccine introduction across countries are primarily driven by differences in cost of labour. Overall estimates generated with the methodology result in costs within the ranges reported for other new vaccines introduced in SSA and capture multiple sources of heterogeneity in costs across countries. Further validation with data from field trials will support use of the methodology while also serving as a validation for cMYP and WHO-CHOICE as resources for costing health interventions in the region.

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Costo estimado de la asistencia prestada a las Partes en el periodo previo a la entrada en vigor del protocolo para la eliminación del comercio ilícito de productos de tabaco: nota de la Secretaría del Convenio
Convenio Marco de la OMS para el Control del Tabaco, Conferencia de las Partes, Órgano de Negociación Intergubernamental de un Protocolo sobre Comercio Ilícito de Productos de Tabaco, quinta reunión, Ginebra (Suiza), 29 de marzo - 4 de abril de 2012 ( 2012 )
El costo futuro de las fracturas de cadera en Alemania [carta] / Manfred Wildner, Waldtraut Casper y Karl E. Bergmann
Wildner, Manfred; Casper, Waldtraut; Bergmann, Karl E ( 1995 )
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Costo y financiamiento de la salud : ¿adónde va el dinero? / Jane Doherty ... [et al.]
Doherty, Jane; McIntyre, Di; Bloom, Gerald; Brijlal, Prem ( 1999 )
Costs and cost-effectiveness of malaria control interventions--a systematic review
Ghani, Azra C; Cibulskis, Richard; Conteh, Lesong; White, Michael T ( 2011-11-03 )
Abstract

BACKGROUND: The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. METHODS: A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. RESULTS: Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54) for ITNs, $6.70 (range $2.22-$12.85) for IRS, $0.60 (range $0.48-$1.08) for IPT in infants, $4.03 (range $1.25-$11.80) for IPT in children, and $2.06 (range $0.47-$3.36) for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34). The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65) and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87). Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110) for ITNs, $143 (range $135-$150) for IRS, and $24 (range $1.08-$44.24) for IPT. CONCLUSIONS: A transparent evidence base on the costs and cost-effectiveness of malaria control interventions is provided to inform rational resource allocation by donors and domestic health budgets and the selection of optimal packages of interventions by malaria control programmes.

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Costs and effects of treatment for psychoactive substance use disorders : framework for evaluation
WHO Programme on Substance Abuse ( 1996 )
Costs and impacts of scaling up voluntary medical male circumcision in Tanzania
Godbole, Ramona; Mahler, Hally; Menon, Veena; Ally, Mariam; Forsythe, Steven; Njeuhmeli, Emmanuel; Castor, Delivette; Gold, Elizabeth ( 2014-05-06 )
Abstract

BACKGROUND: Given the proven effectiveness of voluntary medical male circumcision (VMMC) in preventing the spread of HIV, Tanzania is scaling up VMMC as an HIV prevention strategy. This study will inform policymakers about the potential costs and benefits of scaling up VMMC services in Tanzania. METHODOLOGY: The analysis first assessed the unit costs of delivering VMMC at the facility level in three regions-Iringa, Kagera, and Mbeya-via three currently used VMMC service delivery models (routine, campaign, and mobile/island outreach). Subsequently, using these unit cost data estimates, the study used the Decision Makers' Program Planning Tool (DMPPT) to estimate the costs and impact of a scaled-up VMMC program. RESULTS: Increasing VMMC could substantially reduce HIV infection. Scaling up adult VMMC to reach 87.9% coverage by 2015 would avert nearly 23,000 new adult HIV infections through 2015 and an additional 167,500 from 2016 through 2025-at an additional cost of US$253.7 million through 2015 and US$302.3 million from 2016 through 2025. Average cost per HIV infection averted would be US$11,300 during 2010-2015 and US$3,200 during 2010-2025. Scaling up VMMC in Tanzania will yield significant net benefits (benefits of treatment costs averted minus the cost of performing circumcisions) in the long run-around US$4,200 in net benefits for each infection averted. CONCLUSION: VMMC could have an immediate impact on HIV transmission, but the full impact on prevalence and deaths will only be apparent in the longer term because VMMC averts infections some years into the future among people who have been circumcised. Given the health and economic benefits of investing in VMMC, the scale-up of services should continue to be a central component of the national HIV prevention strategy in Tanzania.

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Costs and performance of malaria surveillance and monitoring in Thailand : a retrospective study based on apportionment of expenditure under budget headings, final report of a project supported by the TDR Social and Economic Research Component / Somkid Kaewsonthi ; with Narathip Cgabogaja, Chilliada Chamarukkula ; advisors, Somthas Malikul, Alan G. Harding
Kaewsonthi, Somkid; Cgabogaja, Narathip; Chamarukkula, Chelliada; UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases ( 1988 )
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Costs associated with the protection of the United States against smallpox / by Norman W. Axnick and J. Michael Lane
Axnick, Norman W; Lane, J. Michael ( 1972 )
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Costs associated with tuberculosis diagnosis and treatment in Yemen for patients and public health services
Othman, G.Q.; lbrahim, M.I.M.; Raja'a, Y.A. ( 2012 )
Abstract

This study determined the costs associated with tuberculosis [TB] diagnosis and treatment for the public health services and patients in Sana'a, Yemen. Data were collected prospectively from 320 pulmonary and extrapulmonary TB patients [160 each] who were followed until completion of treatment. Direct medical and nonmedical costs and indirect costs were calculated. The proportionate cost to the patients for pulmonary TB and extrapulmonary TB was 76.1% and 89.4% respectively of the total for treatment. The mean cost to patients for pulmonary and extrapulmonary TB treatment was US$ 108.4 and US$ 328.0 respectively. The mean cost per patient to the health services for pulmonary and extrapulmonary TB treatment was US$ 34.0 and US$ 38.8 respectively. For pulmonary and extrapulmonary TB, drug treatment represented 59.3% and 77.9% respectively of the total cost to the health services. The greatest proportionate cost to patients for pulmonary TB treatment was time away from work [67.5% of the total cost], and for extrapulmonary TB was laboratory and X-ray costs [55.5%] followed by transportation [28.6%]

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[Costs of basic health services in a health district in Tunisia]
Nouira, A.; Bchir, A.; Njah, M.; Yazid, B.; Bou Ali, S. ( 2004 )
Abstract

Information on the cost of health services is essential for good planning and management and the efficient use of resources. We calculated the total costs incurred in running primary health services for one year [1995] in the health district of Enfidha [Tunisia]. The yearly operating expenditure for the health district was 1 219 099 Tunisian dinars and the cost per inhabitant was 17.494 dinars [US dollar 1 = Tunisian dinar 0.950 in 1995]; 65.37% of total costs went on staff and 17.03% on drugs. Looked at another way, 84,96% went on curative services and 14.04% on preventive services.The cost of a consultation for curative care was 6.847dinars, for perinatal care was 2.764 dinars, for immunization was 3.680 and for school visit was 6.680 dinars. The study helps to identify ways in which cost analysis can be used to explore efficiency and resource adequacy in the district

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania
Watson-Jones, Deborah; Quentin, Wilm; Hayes, Richard; Ross, David A; Changalucha, John; Terris-Prestholt, Fern; Edmunds, W John; Kapiga, Saidi; Soteli, Selephina; Hutubessy, Raymond ( 2012-11-13 )
Abstract

BACKGROUND: Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. METHODS: We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). RESULTS: Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. CONCLUSIONS: Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl.

Costs of diagnostic algorithms: whose perspective counts?
Lönnroth, Knut ( 2015-08-01 )
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Costs of diarrhoeal diseases and the savings from a control programme in Cebu, Philippines / B. C. Forsberg ... [et al.]
Forsberg, B. C; Sullesta, E; Pieche, S; Lambo, N ( 1993 )
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The Costs of HIV prevention strategies in developing countries / N. Söderlund ... [et al.]
Söderlund, Neil; Lavis, J; Broomberg, Jonathan; Mills, A ( 1993 )
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The costs of HIV/AIDS prevention strategies in developing countries
WHO Global Programme on AIDS ( 1993 )
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The costs of home delivery of a birth dose of hepatitis B vaccine in a prefilled syringe in Indonesia / Carol E. Levin .... [et al.]
Levin, Carol E; Nelson, Carib M; Widjaya, Anton; Moniaga, Vanda; Anwar, Chairiyah ( 2005 )
Costs of introducing and delivering HPV vaccines in low and lower middle income countries: inputs for GAVI policy on introduction grant support to countries
Levin, Carol; Wang, Susan A; Levin, Ann; Hutubessy, Raymond; Tsu, Vivien ( 2014-06-26 )
Abstract

BACKGROUND: In November 2011, the GAVI Alliance made the decision to add HPV vaccine as one of the new vaccines for which countries eligible for its funding (less than $1520 per capita income) could apply to receive support for national HPV vaccination, provided they could demonstrate the ability to deliver HPV vaccines. This paper describes the data and analysis shared with GAVI policymakers for this decision regarding GAVI HPV vaccine support. The paper reviews why strategies and costs for HPV vaccine delivery are different from other vaccines and what is known about the cost components from available data that originated primarily from HPV vaccine delivery costing studies in low and middle income-countries. METHODS: Financial costs of HPV vaccine delivery were compared across three sources of data: 1) vaccine delivery costing of pilot projects in five low and lower-middle income countries; 2) cost estimates of national HPV vaccination in two low income countries; and 3) actual expenditure data from national HPV vaccine introduction in a low income country. Both costs of resources required to introduce the vaccine (or initial one-time investment, such as cold chain equipment purchases) and recurrent (ongoing costs that repeat every year) costs, such as transport and health personnel time, were analyzed. The cost per dose, cost per fully immunized girl (FIG) and cost per eligible girl were compared across studies. RESULTS: Costs varied among pilot projects and estimates of national programs due to differences in scale and service delivery strategy. The average introduction costs per fully immunized girl ranged from $1.49 to $18.94 while recurrent costs per girl ranged from $1.00 to $15.69, with both types of costs varying by delivery strategy and country. Evaluating delivery costs along programme characteristics as well as country characteristics (population density, income/cost level, existing service delivery infrastructure) are likely the most informative and useful for anticipating costs for HPV vaccine delivery. CONCLUSIONS: This paper demonstrates the importance of country level cost data to inform global donor policies for vaccine introduction support. Such data are also valuable for informing national decisions on HPV vaccine introduction.

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