A systematic review of scope and quality of health economic evaluations conducted in Ethiopia

Daniel Erku; Amanual G Mersha; Eskinder Eshetu Ali; Gebremedhin B Gebretekle; Befikadu L Wubishet; Gizat Molla Kassie; Anwar Mulugeta; Alemayehu B Mekonnen; Tesfahun C Eshetie; Paul Scuffham

doi:10.1093/heapol/czac005

A systematic review of scope and quality of health economic evaluations conducted in Ethiopia

Health Policy Plan. 2022 Apr 12;37(4):514-522. doi: 10.1093/heapol/czac005.

Authors

Daniel Erku^{1

2

3}, Amanual G Mersha⁴, Eskinder Eshetu Ali⁵, Gebremedhin B Gebretekle^{6

7}, Befikadu L Wubishet⁸, Gizat Molla Kassie⁹, Anwar Mulugeta^{10

11

12}, Alemayehu B Mekonnen¹³, Tesfahun C Eshetie¹⁴, Paul Scuffham^{1

2}

Affiliations

¹ Centre for Applied Health Economics, Griffith University, Nathan, QLD, Australia.
² Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
³ Addis Consortium for Health Economics and Outcomes Research (AnCHOR).
⁴ School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.
⁵ Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University 251, Yared Street, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
⁶ Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
⁷ Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada.
⁸ Health Services Research Centre Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, 4006, Brisbane, Australia.
⁹ Quality Use of Medicines and Pharmacy Research Centre, University of South Australia: Clinical & Health Sciences, Adelaide, SA 5000, Australia.
¹⁰ Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.
¹¹ Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa 1000, Ethiopia.
¹² South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.
¹³ Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
¹⁴ Plein Center for Geriatric Pharmacy Research, Education and Outreach, School of Pharmacy, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195-7630, USA.

Abstract

There has been an increased interest in health technology assessment and economic evaluations for health policy in Ethiopia over the last few years. In this systematic review, we examined the scope and quality of healthcare economic evaluation studies in Ethiopia. We searched seven electronic databases (PubMed/MEDLINE, EMBASE, PsycINFO, CINHAL, Econlit, York CRD databases and CEA Tufts) from inception to May 2021 to identify published full health economic evaluations of a health-related intervention or programme in Ethiopia. This was supplemented with forward and backward citation searches of included articles, manual search of key government websites, the Disease Control Priorities-Ethiopia project and WHO-CHOICE programme. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. The extracted data were grouped into subcategories based on the subject of the economic evaluation, organized into tables and reported narratively. This review identified 34 full economic evaluations conducted between 2009 and 2021. Around 14 (41%) of studies focussed on health service delivery, 8 (24%) on pharmaceuticals, vaccines and devices, and 4 (12%) on public-health programmes. The interventions were mostly preventive in nature and focussed on communicable diseases (n = 19; 56%) and maternal and child health (n = 6; 18%). Cost-effectiveness ratios varied widely from cost-saving to more than US $37 313 per life saved depending on the setting, perspectives, types of interventions and disease conditions. While the overall quality of included studies was judged as moderate (meeting 69% of CHEERS checklist), only four out of 27 cost-effectiveness studies characterized heterogeneity. There is a need for building local technical capacity to enhance the design, conduct and reporting of health economic evaluations in Ethiopia.

Keywords: Ethiopia; cost-effectiveness; economic evaluation.

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Publication types

Systematic Review

MeSH terms

Child
Cost-Benefit Analysis
Äthiopien
Health Policy*
Humans
Technology Assessment, Biomedical*