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Non-communicable Disease Prevention: Best Buys, Wasted Buys and Contestable Buys
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Contents

Forewords

vii

Acknowledgements

xv

Notes on Contributors

xix

1.

Introduction

1

Wanrudee Isaranuwatchai, Rachel A. Archer and Anthony J. Culyer

1.1

Non-Communicable Disease

1

1.2

Best, Wasted and Contestable Buys

5

1.3

Definitions and Central Ideas

6

Box 1.1 Definitions of Basic Terminology Used in Economic Evaluation

7

1.4

The Cost-Effectiveness Plane

8

1.5

The Story of This Book

12

1.6

The Project and Its Output

13

1.7

The Project Journey

13

1.8

Target Audience

15

2.

Non-Communicable Diseases, NCD Program Managers and the Politics of Progress

17

Sumithra Krishnamurthy Reddiar and Jesse B. Bump

2.1

Background

17

2.2

Methods for Interviews and Analysis

19

2.3

Institutions: NCD Managers, NCD Units and Ministries of Health

21

2.4

Interests: Stakeholders and Power

26

2.5

Ideas: Evidence, Knowledge and Values

28

2.6

Discussion

33

2.7

Limitations

38

2.8

Conclusions and Recommendations

38

3.

Framework for Implementing Best Buys and Avoiding Wasted Buys

41

Yot Teerawattananon, Alia Luz, Manushi Sharma and Waranya Rattanavipapong

3.1

Consideration One

42

3.2

Consideration Two

44

3.3

Consideration Three

45

3.4

Consideration Four

46

3.5

Consideration Five

47

3.6

The SEED Tool in Practice

48

4.

Best Buys

51

Tazeem Bhatia, Arisa Shichijo and Ryota Nakamura

4.1

Introduction

51

4.1.1

Background

51

4.1.2

What This Chapter Offers

54

4.2

Determining Important Contextual Factors in NCD Prevention

55

4.3

Policymaking Challenges and Cost-Effectiveness Data

60

Investigating Case Studies

61

Case Study 4.4.1 Cardiovascular screening in Sri Lanka

61

Case Study 4.4.2 Prevention and control of cervical cancer in Cambodia

63

Case Study 4.4.3 Sugar-Sweetened Beverage (SSB) taxes

64

4.5

Discussion

66

4.6

Conclusion

68

5.

Wasted Buys

71

Yot Teerawattananon, Manushi Sharma, Alia Luz, Waranya Rattanavipapong and Adam G. Elshaug

5.1

Introduction

71

5.1.1

What Are ‘Wasted Buys’?

72

5.1.2

The ‘Area of Uncertainty’

74

5.2

Exploring Wasted Buys in Low- and Middle-Income Countries (LMICs)

75

A. Cochrane Collaboration Database

75

B. The Global Health Cost-Effectiveness Analysis (GH CEA) Registry

76

C. Disease Control Priorities (DCP)

76

Case Study 5.2.1 Mass-media campaigns for prevention of NCDs

77

Case Study 5.2.2 Cost-effectiveness of medical primary prevention strategies to reduce the risk of cardiovascular disease (CVD) in Tanzania

79

Case Study 5.2.3 Diabetes screening in Thailand and Indonesia

80

Case Study 5.2.4 Drug testing in Bhutan

82

5.3

Common Features of Wasted Buys

84

5.3.1

The Fallacy that Prevention Interventions Are Always Best Buys

85

5.3.2

One Size Seldom Fits All in International Guidelines

85

5.3.3

Policy-Based Evidence Versus Evidence-Based Policy

86

5.3.4

Selective Implementation of Interventions

86

5.3.5

Low CE Threshold Used for Decision-Making

87

5.4

Recommendations

88

6.

Assessing the Transferability of Economic Evaluations: A Decision Framework

91

David D. Kim, Rachel L. Bacon and Peter J. Neumann

6.1

Introduction

91

6.2

Review of the Literature

95

6.3

A Decision Framework for Identifying Locally-Relevant Best and Wasted Buys

97

6.3.1

Background

97

6.3.2

A Decision Framework and a Transferability Assessment Checklist

98

Step 1: Initial Assessment of Study Design

102

A. Study Perspective

102

B. Intervention and its Comparator(s)

103

C. Time Horizon

103

D. Discounting

104

E. Study Quality

104

Step 2: Data Transferability Assessment

105

A. Baseline Risk (Disease Profile)

106

B. Treatment Effects (Clinical Information)

106

C. Unit Costs/Prices

106

D. Resource Utilization

107

E. Health-State Preference Weight

107

6.4

Worked Example: Assessing Transferability of Best Buy Interventions for Diabetes Prevention and Management in Kenya

109

6.4.1

Background and Rationale

109

6.4.2

Evaluator’s Guideline on Economic Evaluation

110

6.4.3

Transferability Assessment Process

111

6.4.4

Transferability Assessment Results

114

6.5

Using the Impact Inventory

116

6.6

Conclusion and Next Steps

117

7.

Finding the Best Evidence

119

Thunyarat Anothaisintawee

7.1

Determining the Impact of Behavior Change on NCDs Through Research

119

Case Study 7.1.1 Knowledge growth: A case study of low-calorie sweeteners

119

7.2

Types of Study Design

120

7.3

Quality Assessment of Studies/Evidence

121

7.4

Types of Evidence Synthesis

123

Case Study 7.4.1 Efficacy of lifestyle interventions and effect of lifestyle factors on the risk of type 2 diabetes mellitus, cardiovascular diseases and hypertension: An umbrella review

125

7.5

Role of Environmental Interventions in Changing Health Behavior

126

7.6

Conclusion

128

8.

Cross-Sectoral Policies to Address Non-Communicable Diseases

129

Melitta Jakab and Peter C. Smith

8.1

Introduction

129

8.2

Why Are Cross-Sectoral Policies So Challenging?

132

8.3

Analytic Framework

134

8.4

Institutional Requirements

137

8.5

Types of Cross-Sectoral Policies

140

Case Study 8.5.1 The public catering decree in Hungary

141

Case Study 8.5.2 Employing people with disabilities in Croatia

142

8.6

Conclusions

144

8.7

Analytical Appendix

145

9.

Deliberative Processes in Decisions about Best Buys, Wasted Buys and Contestable Buys: Uncertainty and Credibility

147

Kalipso Chalkidou and Anthony J. Culyer

9.1

Introduction

147

9.2

Criteria, Opportunity Costs and Social Value Judgments: A Role for Deliberation

148

9.3

Deliberation Contrasted with Algorithms

150

9.4

Evidence

152

Box 9.1 Categories of Evidence

152

9.5

Uncertainty

159

9.6

Credibility

159

9.7

Some Characteristics of Deliberative Processes

163

Case Study 9.7.1 The (then) National Institute for Clinical Excellence (England and Wales)

164

9.8

Conclusions

168

10.

Summing Up

171

Wanrudee Isaranuwatchai, Rachel A. Archer and Anthony J. Culyer

Glossary of Abbreviations

175

List of Illustrations and Tables

179

Online Appendixes: https://hdl.handle.net/20.500.12434/09617d51