UNDERSTANDING PRIORITIES IN HEALTH ECONOMICS: MAPPING COST-EFFECTIVENESS AND DISEASE BURDEN TRENDS
Author(s)
Fariel LaMountain, BA, Patricia Synnott, PhD;
Tufts Medical Center, Center for the Evaluation of Value and Risk in Health (CEVR), Boston, MA, USA
Tufts Medical Center, Center for the Evaluation of Value and Risk in Health (CEVR), Boston, MA, USA
OBJECTIVES: Arguably, research priorities should address the most pressing health needs. This analysis explores how research priorities in cost-effectiveness analysis (CEA) align with burden of disease trends.
METHODS: We used data from the Tufts CEA Registry to identify CEAs published between 1990 and 2021. We compared cumulative publication volume at the country-level with disability-adjusted life year (DALY) estimates from the Global Burden of Disease Study, stratified by Tier 1 categories (non-communicable disease; communicable, maternal, neonatal, and nutritional disease; and injuries). We explored CEA alignment by geographic region and income group per 2021 World Bank categorization.
RESULTS: We identified 10,646 unique publications between 1990 and 2021 with cost-effectiveness data for 204 countries/territories, totaling 15,861 country-relevant CEA publications (i.e., publications spanning multiple countries were counted once per country). Globally, non-communicable diseases accounted for the highest disease burden (2,969 million DALYs) and country-relevant CEA publications (n = 9,057) in 2021, followed by communicable diseases (699 million DALYs; n = 5,738), and injuries (248 million DALYs; n = 1,066). In 4 of 7 regions (Latin America and Caribbean, Middle East and North Africa, South Asia, and Sub-Saharan Africa), most CEAs evaluated communicable diseases despite non-communicable disease contributing the highest disease burden across all except Sub-Saharan Africa (182 versus 348 million DALYs from communicable disease). South Asia was the only region to flip from communicable to non-communicable disease as the leading cause of disease burden. Low- and lower-middle-income countries (LLMICs) showed the same flip in 2016, though communicable diseases accounted for 74.8% of publications in 2021.
CONCLUSIONS: While global trends in disease burden and CEA publications reflect rises in non-communicable disease, regional and income group stratification reveals that CEA publication trends have not yet caught up. These findings highlight the need to address the significant gap in CEAs for non-communicable disease in LLMICs.
METHODS: We used data from the Tufts CEA Registry to identify CEAs published between 1990 and 2021. We compared cumulative publication volume at the country-level with disability-adjusted life year (DALY) estimates from the Global Burden of Disease Study, stratified by Tier 1 categories (non-communicable disease; communicable, maternal, neonatal, and nutritional disease; and injuries). We explored CEA alignment by geographic region and income group per 2021 World Bank categorization.
RESULTS: We identified 10,646 unique publications between 1990 and 2021 with cost-effectiveness data for 204 countries/territories, totaling 15,861 country-relevant CEA publications (i.e., publications spanning multiple countries were counted once per country). Globally, non-communicable diseases accounted for the highest disease burden (2,969 million DALYs) and country-relevant CEA publications (n = 9,057) in 2021, followed by communicable diseases (699 million DALYs; n = 5,738), and injuries (248 million DALYs; n = 1,066). In 4 of 7 regions (Latin America and Caribbean, Middle East and North Africa, South Asia, and Sub-Saharan Africa), most CEAs evaluated communicable diseases despite non-communicable disease contributing the highest disease burden across all except Sub-Saharan Africa (182 versus 348 million DALYs from communicable disease). South Asia was the only region to flip from communicable to non-communicable disease as the leading cause of disease burden. Low- and lower-middle-income countries (LLMICs) showed the same flip in 2016, though communicable diseases accounted for 74.8% of publications in 2021.
CONCLUSIONS: While global trends in disease burden and CEA publications reflect rises in non-communicable disease, regional and income group stratification reveals that CEA publication trends have not yet caught up. These findings highlight the need to address the significant gap in CEAs for non-communicable disease in LLMICs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE413
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas