Introduction : Economic evaluations can provide “value-for money” information to those making decisions about the allocation of limited health care resources. In particular, economic evaluations can be used to identify interventions that are worth providing and those that are not. Furthermore, evaluations can be used with other approaches to help set priorities, such as program-budgeting marginal-analysis.
Methodology : Compile and systematically describe from the publications, articles and reports on economic evaluation in healthcare decision making.
Result : A high quality economic evaluation should provide decision makers with information that is useful, relevant, and timely. In addition, evaluations should be based on rigorous analytical methods, be balanced and impartial (credible), and be transparent and accessible to the reader. There are many situations where economic evaluations can assist decision makers: decisions by various levels of government or administrative bodies (e.g., regional health authorities, hospitals, drug plans) to fund a program, service or technology, pricing decisions by government regulators and technology manufacturers, clinical practice guidelines, priorities for research funding by governments and researchbased firms, post-marketing surveillance and updates of economic information based on the use of the technology in the “real world” (which can then be used to inform one of the other types of decisions).
Conclusion: This requires that decision makers take a broad view of the impact of a technology, and decision that are more explicit and transparent. The ultimate test of an evaluation is whether it leads to better decision in the presence of uncertainty, and results in the more efficient and effective use of resources.
Nipah virus (NiV) is an emerging bat-borne zoonotic virus that causes near-annual outbreaks of fatal encephalitis in South Asia-one of the most populous regions on Earth. In Bangladesh, infection occurs when people drink date-palm sap contaminated with bat excreta. Outbreaks are sporadic, and the influence of viral dynamics in bats on their temporal and spatial distribution is poorly understood. We analyzed data on host ecology, molecular epidemiology, serological dynamics, and viral genetics to characterize spatiotemporal patterns of NiV dynamics in its wildlife reservoir, Pteropus medius bats, in Bangladesh. We found that NiV transmission occurred throughout the country and throughout the year. Model results indicated that local transmission dynamics were modulated by density-dependent transmission, acquired immunity that is lost over time, and recrudescence. Increased transmission followed multiyear periods of declining seroprevalence due to bat-population turnover and individual loss of humoral immunity. Individual bats had smaller host ranges than other Pteropus species (spp.), although movement data and the discovery of a Malaysia-clade NiV strain in eastern Bangladesh suggest connectivity with bats east of Bangladesh. These data suggest that discrete multiannual local epizootics in bat populations contribute to the sporadic nature of NiV outbreaks in South Asia. At the same time, the broad spatial and temporal extent of NiV transmission, including the recent outbreak in Kerala, India, highlights the continued risk of spillover to humans wherever they may interact with pteropid bats and the importance of limiting opportunities for spillover throughout Pteropus's range.