Skip to main content

Considerations for Developing Applied Health Policy Models: The Example of HIV Treatment Expansion in Resource-Limited Settings

  • Chapter
  • First Online:
Operations Research and Health Care Policy

Abstract

This chapter describes steps for developing health policy models. The discussion begins with considerations for identifying a research question and developing a model conceptual framework. It next provides guidance on how to build and implement the model, as well as how to populate or parameterize a model. We end by examining the techniques for verifying model performance. Special emphasis is placed on developing applied health policy models, particularly those used to inform policy decisions in resource-limited settings.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Weinstein MC, Toy EL, Sandberg EA, Neumann PJ, Evans JS et al. (2001) Modeling for health care and other policy decisions: uses, roles, and validity. Value Health 4:348–361

    Article  Google Scholar 

  2. Earp JA, Ennett ST (1991) Conceptual models for health education research and practice. Health Educ Res 6:163–171

    Article  Google Scholar 

  3. Paradies Y, Stevens M (2005) Conceptual diagrams in public health research. J Epidemiol Community Health 59:1012–1013

    Article  Google Scholar 

  4. (2008) Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet 372:293–299

    Google Scholar 

  5. Lima VD, Hogg RS, Harrigan PR, Moore D, Yip B et al. (2007) Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy. AIDS 21:685–692

    Article  Google Scholar 

  6. Mills EJ, Bakanda C, Birungi J, Chan K, Ford N et al. (2011) Life expectancy of persons receiving combination antiretroviral therapy in low-income countries: a cohort analysis from Uganda. Ann Intern Med 155:209–216

    Google Scholar 

  7. World Health Organization, UNAIDS, UNICEF (2010) Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress Report 2010. World Health Organization, Geneva. http://www.who.int/hiv/pub/2010progressreport/summary_en.pdf

  8. Clinton HR (2011) Remarks on “creating an AIDS-free generation”. Bethesda. http://www.state.gov/secretary/rm/2011/11/176810.htm

  9. Bonnel R, de Beyer J, Bennett D (2009) The global economic crisis and HIV prevention and treatment programmes: vulnerabilities and impact. The World Bank and UNAIDS. http://data.unaids.org/pub/Report/2009/jc1734_econ_crisis_hiv_response_en.pdf

  10. Kates J, Wexler A, Lief E, Avila C, Gobet B (2011) Financing the response to AIDS in low- and middle-income countries: international assistance from the G8, European Commission and other donor governments in 2010. http://www.kff.org/hivaids/upload/7347–07.pdf

  11. Moszynski P (2011) Global fund suspends new projects until 2014 because of lack of funding. BMJ 343:d7755

    Article  Google Scholar 

  12. Rosen S, Fox MP, Gill CJ (2007) Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med 4:e298

    Article  Google Scholar 

  13. World Health Organization (2011) Global health sector strategy on HIV/AIDS 2011–2015. World Health Organization. http://whqlibdoc.who.int/publications/2011/9789241501651_eng.pdf

  14. World Health Organization (2010) Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. 2010 revision. http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf

  15. World Health Organization (2006) Antiretroviral therapy for HIV infection in adults and adolescents in resource-limited settings: towards universal access. Recommendations for a public health approach. 2006 revision. World Health Organization,Geneva. http://www.who.int/hiv/pub/guidelines/artadultguidelines.pdf

  16. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC et al. (2011) Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 365:493–505

    Article  Google Scholar 

  17. Donnell D, Baeten JM, Kiarie J, Thomas KK, Stevens W et al. (2010) Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet 375:2092–2098

    Article  Google Scholar 

  18. Walensky RP, Wood R, Fofana MO, Martinson NA, Losina E et al. (2011) The clinical impact and cost-effectiveness of routine, voluntary HIV screening in South Africa. J Acquir Immune Defic Syndr 56:26–35

    Article  Google Scholar 

  19. Kimmel AD, Weinstein MC, Anglaret X, Goldie SJ, Losina E et al. (2010) Laboratory monitoring to guide switching antiretroviral therapy in resource-limited settings: clinical benefits and cost-effectiveness. J Acquir Immune Defic Syndr 54:258–268

    Article  Google Scholar 

  20. Bishai D, Colchero A, Durack DT (2007) The cost effectiveness of antiretroviral treatment strategies in resource-limited settings. AIDS 21:1333–1340

    Article  Google Scholar 

  21. Bendavid E, Grant P, Talbot A, Owens DK, Zolopa A (2011) Cost-effectiveness of antiretroviral regimens in the World Health Organization’s treatment guidelines: a South African analysis. AIDS 25:211–220

    Article  Google Scholar 

  22. Braithwaite RS, Nucifora KA, Yiannoutsos CT, Musick B, Kimaiyo S et al. (2011) Alternative antiretroviral monitoring strategies for HIV-infected patients in east Africa: opportunities to save more lives? J Int AIDS Soc 14:38

    Article  Google Scholar 

  23. Kuntz KM, Weinstein MC (2001) Modelling in economic evaluation. In: Drummond M, McGuire A (eds) Economic evaluation in health care: merging theory with practice. Oxford University Press, New York

    Google Scholar 

  24. Dewilde S, Anderson R (2004) The cost-effectiveness of screening programs using single and multiple birth cohort simulations: a comparison using a model of cervical cancer. Med Decis Making 24:486–492

    Article  Google Scholar 

  25. Beck JR, Pauker SG (1983) The Markov process in medical prognosis. Med Decis Making 3:419–458

    Article  Google Scholar 

  26. Sonnenberg FA, Beck JR (1993) Markov models in medical decision making: a practical guide. Med Decis Making 13:322–338

    Article  Google Scholar 

  27. Benbassat J, Baumal R (2007) The time horizons of formal decision analyses. QJM 100:383–388

    Article  Google Scholar 

  28. Naimark D, Krahn MD, Naglie G, Redelmeier DA, Detsky AS (1997) Primer on medical decision analysis: part 5—working with Markov processes. Med Decis Making 17:152–159

    Article  Google Scholar 

  29. Price MJ, Briggs AH (2002) Development of an economic model to assess the cost effectiveness of asthma management strategies. Pharmacoeconomics 20:183–194

    Article  Google Scholar 

  30. Stahl JE (2008) Modelling methods for pharmacoeconomics and health technology assessment: an overview and guide. Pharmacoeconomics 26:131–148

    Article  Google Scholar 

  31. Weinstein MC, O’Brien B, Hornberger J, Jackson J, Johannesson M et al. (2003) Principles of good practice for decision analytic modeling in health-care evaluation: report of the ISPOR task force on good research practices—modeling studies. Value Health 6:9–17

    Article  Google Scholar 

  32. Goldie SJ, Corso PS (2003) Decision analysis. In: Haddix AC, Teutsch SM, Corso PS (eds) Prevention effectiveness, 2nd edn. Oxford University Press, New York

    Google Scholar 

  33. Siebert U, Alagoz O, Bayoumi AM, Jahn B, Owens DK et al. (In press) State-transition modeling: a report of the ISPOR-SMDM modeling good research practices task force working group—part 5. Value Health

    Google Scholar 

  34. Kimmel AD, Fitzgerald DW, Charles M, Edwards AM, Marcelin A et al. (2012) Internal validation and calibration of a model to forecast HIV treatment demand and capacity in Haiti. Med Decis Making 32:E123

    Google Scholar 

  35. Alistar SS, Brandeau ML (2012) Decision making for HIV prevention and treatment scale up: bridging the gap between theory and practice. Med Decis Making 32:105–117

    Article  Google Scholar 

  36. Weinstein MC (2006) Recent developments in decision-analytic modelling for economic evaluation. Pharmacoeconomics 24:1043–1053

    Article  Google Scholar 

  37. Kuntz KM, Weinstein MC (1995) Life expectancy biases in clinical decision modeling. Med Decis Making 15:158–169

    Article  Google Scholar 

  38. UNAIDS (2011) AIDSinfo database. http://www.aidsinfoonline.org/

  39. Greasley A (1998) An example of a discrete-event simulation on a spreadsheet. Simulation 70:148–166

    Article  Google Scholar 

  40. Briggs AH, Fenwick E, Karnon J, Paltiel AD, Schulpher M et al. (2012) DRAFT model parameter estimation and uncertainty: a report of the ISPOR-SMDM modeling good research practices task force working group-6. http://www.ispor.org/workpaper/modeling_methods/DRAFT-Modeling-Task-Force_Model-Parameter-Estimation-and-Uncertainty-Report.pdf

  41. Porta MS (ed) (2008) A dictionary of epidemiology. Oxford University Press, Oxford

    Google Scholar 

  42. Lindgren BW (1993) Statistical theory. Chapman & Hall, New York, NY

    Google Scholar 

  43. Briggs AH, Claxton K, Sculpher M (2006) Decision modelling for health economic evaluation.Oxford University Press, New York

    Google Scholar 

  44. Concato J, Peduzzi P, Huang GD, O’Leary TJ, Kupersmith J (2010) Comparative effectiveness research: what kind of studies do we need? J Investig Med 58:764–769

    Google Scholar 

  45. Gold MR, Siegel JE, Russell LB, Weinstein MC (eds) (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York

    Google Scholar 

  46. Taylor DC, Pawar V, Kruzikas D, Gilmore KE, Pandya A et al. (2010) Methods of model calibration: observations from a mathematical model of cervical cancer. Pharmacoeconomics 28:995–1000

    Article  Google Scholar 

  47. Eddy DM, Hollingworth W, Caro JJ, Tsevat J, McDonald KM et al. (2012) DRAFT—model transparency and validation: a report of the ISPOR-SMDM modeling good research practices task force working group—part 4. http://www.ispor.org/workpaper/modeling_methods/DRAFT-Modeling-Task-Froce_Validation-and-Transparency-Report.pdf

  48. Stout NK, Knudsen AB, Kong CY, McMahon PM, Gazelle GS (2009) Calibration methods used in cancer simulation models and suggested reporting guidelines. Pharmacoeconomics 27:533–545

    Article  Google Scholar 

  49. McCabe C, Dixon S (2000) Testing the validity of cost-effectiveness models. Pharmacoeconomics 17:501–513

    Article  Google Scholar 

  50. Karnon J, Vanni T (2011) Calibrating models in economic evaluation: a comparison of alternative measures of goodness of fit, parameter search strategies and convergence criteria. Pharmacoeconomics 29:51–62

    Article  Google Scholar 

  51. Vanni T, Karnon J, Madan J, White RG, Edmunds WJ et al. (2011) Calibrating models in economic evaluation: a seven-step approach. Pharmacoeconomics 29:35–49

    Article  Google Scholar 

  52. Hammerschmidt T, Goertz A, Wagenpfeil S, Neiss A, Wutzler P et al. (2003) Validation of health economic models: the example of EVITA. Value Health 6:551–559

    Article  Google Scholar 

  53. Kim JJ, Kuntz KM, Stout NK, Mahmud S, Villa LL et al. (2007) Multiparameter calibration of a natural history model of cervical cancer. Am J Epidemiol 166:137–150

    Article  Google Scholar 

  54. Salomon JA, Weinstein MC, Hammitt JK, Goldie SJ (2002) Empirically calibrated model of hepatitis C virus infection in the United States. Am J Epidemiol 156:761–773

    Article  Google Scholar 

  55. Yeh JM, Kuntz KM, Ezzati M, Hur C, Kong CY et al. (2008) Development of an empirically calibrated model of gastric cancer in two high-risk countries. Cancer Epidemiol Biomarkers Prev 17:1179–1187

    Article  Google Scholar 

  56. Rydzak CE, Cotich KL, Sax PE, Hsu HE, Wang B et al. (2010) Assessing the performance of a computer-based policy model of HIV and AIDS. PLoS One 5(9):e12647

    Article  Google Scholar 

  57. Vanni T, Legood R, White RG (2010) Calibration of disease simulation model using an engineering approach. Value Health 13:157

    Article  Google Scholar 

  58. Fryback DG, Stout NK, Rosenberg MA, Trentham-Dietz A, Kuruchittham V et al. (2006) The wisconsin breast cancer epidemiology simulation model. J Natl Cancer Inst Monogr (36):37–47

    Article  Google Scholar 

  59. UNAIDS (2011) Country fact sheet: Haiti. http://www.unaids.org/en/dataanalysis/tools/aidsinfo/countryfactsheets/

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to April D. Kimmel .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kimmel, A.D., Schackman, B.R. (2013). Considerations for Developing Applied Health Policy Models: The Example of HIV Treatment Expansion in Resource-Limited Settings. In: Zaric, G. (eds) Operations Research and Health Care Policy. International Series in Operations Research & Management Science, vol 190. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6507-2_15

Download citation

Publish with us

Policies and ethics