Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia

被引:1
作者
Simangolwa, Warren Mukelabai [1 ,3 ]
Govender, Kaymarlin [1 ,2 ]
Mbonigaba, Josue [2 ]
机构
[1] Univ KwaZulu Natal, Hlth Econ & HIV AIDs Res Div, Durban, South Africa
[2] Univ KwaZulu Natal, Coll Law & Management Sci, Durban, South Africa
[3] Patient & Citizen Involvement Hlth, Ctr Hlth Econ Financing & Technol Assessment, POB 310159,3739 Kwacha Rd, Lusaka, Zambia
关键词
Health technology assessment; Health benefits package; Economic evaluation; Cost-effectiveness analysis; Cost; Systematic review; COST-EFFECTIVENESS THRESHOLDS; TO-CHILD TRANSMISSION; TREATMENT INTERVENTION; SOUTHERN PROVINCE; INCREMENTAL COST; INCOME COUNTRIES; MALARIA CONTROL; MIDDLE-INCOME; HIV; CARE;
D O I
10.1186/s12913-024-11914-z
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BackgroundHealth technology assessment uses explicit economic evaluation evidence to support health benefits package design. However, the limited availability of technical expertise, data, and methods has restricted the production of economic evaluation evidence in low- and middle-income countries. Zambia has initiated a roadmap to support its policy of reviewing and implementing its national benefits package. This study characterises economic evaluation evidence to support this process's evidence mapping, synthesis, and appraisal stages.MethodsThis systematic review applies deductive analysis and the preferred reporting items for systematic review and meta-analyses. Four databases were searched to identify studies from 1993 that coincided with Zambia's health benefits package reform.ResultsA total of 61 studies met the inclusion criteria. Most of the studies were first authored by nonlocal authors, and the number of local-based authors in each study was low. Almost all funding for economic evaluation research was not local, and only a few studies sought local ethical clearance to conduct research. Infectious diseases were the highest disease control priority for the studies, with HIV research having the highest output. Most of the studies were cost-effectiveness studies that utilised trial-based data and a combination of program, published, and unpublished data for analysis. The studies generally utilised direct cost and applied the ingredient-based costing approach. Natural units were predominantly used for outcomes alongside DALYs. Most studies reported using a 3% discount rate for both costs and outcomes, with only a few reporting methods for sensitivity analysis.ConclusionEconomic evaluation evidence in Zambia has increased, revealing limited local research leadership, methodological inconsistencies, and a focus on infectious diseases. These findings are crucial for revising Zambia's benefits package and may guide researchers and decision-makers in improving the transparency and quality of future research.
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