Economic evaluations of non-communicable diseases conducted in Sub-Saharan Africa: a critical review of data sources
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Cost Effectiveness and Resource Allocation
Abstract
Background Policymakers in sub-Saharan Africa (SSA) face challenging decisions regarding the allocation of health
resources. Economic evaluations can help decision makers to determine which health interventions should be
funded and or included in their benefits package. A major problem is whether the evaluations incorporated data from
sources that are reliable and relevant to the country of interest. We aimed to review the quality of the data sources
used in all published economic evaluations for cardiovascular disease and diabetes in SSA.
Methods We systematically searched selected databases for all published economic evaluations for CVD and
diabetes in SSA. We modified a hierarchy of data sources and used a reference case to measure the adherence to
reporting and methodological characteristics, and descriptively analysed author statements.
Results From 7,297 articles retrieved from the search, we selected 35 for study inclusion. Most were modelled
evaluations and almost all focused on pharmacological interventions. The studies adhered to the reporting standards
but were less adherent to the methodological standards. The quality of data sources varied. The quality level of
evidence in the data domains of resource use and costs were generally considered of high quality, with studies often
sourcing information from reliable databases within the same jurisdiction. The authors of most studies referred to data
sources in the discussion section of the publications highlighting the challenges of obtaining good quality and locally
relevant data.
Conclusions The data sources in some domains are considered high quality but there remains a need to make
substantial improvements in the methodological adherence and overall quality of data sources to provide evidence
that is sufficiently robust to support decision making in SSA within the context of UHC and health benefits plans.
Many SSA governments will need to strengthen and build their capacity to conduct economic evaluations of
interventions and health technology assessment for improved priority setting. This capacity building includes
enhancing local infrastructures for routine data production and management. If many of the policy makers are using
economic evaluations to guide resource allocation, it is imperative that the evidence used is of the feasibly highest
quality.
Description
Research Article
Keywords
Economic evaluations, diseases