How much does it cost? Development of an HIV/TB Unit Cost Study Repository and UCost Tool Willyanne DeCormier Plosky and Lori Bollinger July 20, 2018 IAEN Pre-Conference Amsterdam, Netherlands

UCSR Overview History: Need for ACCESS to centralized cost data source; availability of pertinent information to assess the QUALITY of cost estimates, without overwhelming the user with data. Need for ability to sort data by key characteristics: region, country, type of intervention, platform, etc. Builds upon previous [Avenir Health] version which was for HIV only and for studies up to 2013. The new and improved version covers studies up until mid-year 2016 in HIV and TB, with more detailed extraction. It currently includes 219 studies in HIV and TB, and 1277 unique unit cost estimates.

UCSR overview: welcome screen Available for you to test at: https://ghcosting.org (under data)

UCSR overview: RC-compatible How does the UCSR align with the Reference Case? The RC improves the quality of new studies by providing guidance on important principles, methods, and reporting standards. These are utilized in the UCSR to frame the key characteristics for the cost estimates on the main results page, and the grouping for more information in the secondary pages. The RC guidance not only helps data PRODUCERS to improve the quality of forthcoming studies, but also allows data USERS to interpret the quality of existing cost estimates. By following the RC guidance in the structure of the UCSR, users of cost data can better assess the quality of cost estimates, and understand why cost estimates for the same intervention and in the same country may differ significantly from each other.

UCSR: Step #1 – Main This page aligns with the first principle of the RC: the purpose, the population, and the intervention and/or service/output of the cost estimation should be defined. The purpose is not explicit in the UCSR. However, the Disease, Intervention Class and Intervention align with the Typology- which is drawn from how partners structure their programming and budgets.

UCSR: Step #2 – See results/Refine Filtering: This page aligns with Principle 1 of the RC (Intervention detail), and with Principles 2 (Perspective), 3 (Type of cost), 4 (Unit definition), 6 (Scope), and 16 (Uncertainty) For the units, we have standardized the units, which are clearly displayed in terms of the “level” of the unit and the timeframe. We also have a sub-study unique trait that gives further explanation of how the cost may “fit” within that standardized unit, as authors report many different splices of a unit such as per person treated.

UCSR: Step #2- More information The second level is divided into: Study attributes, Cost disaggregations, and Alerts. “Study attributes” covers more of the RC principles, such as Principles 8 (Sampling), 10 (Timing of data collection), and 12 (Valuing capital inputs).

UCSR: Step #3 – Charts (cont’d) Visualization Depending on scenario selected, there are different types of charts. The charts assist with RC principle 15 (Exploring heterogeneity). The GHCC has been working with teams in Immunization, Malaria, Social Behavioral Change (primarily in Family Planning), and with individual country teams that want to develop similar databases, and potentially be able to integrate into the UCSR.

UCost tool overview How does this align with the primary (and literature) data analysis? The objective of the analytical work is to combine data on costs of VMMC services from several independent studies (and from literature), to estimate average intervention unit costs (including fixed and variable costs) by country where there is data, extrapolate unit costs to areas where there is absence of information, and to identify drivers of VMMC outputs and input costs. Review of the “User journey” for UCost: Unified look with the UCSR Same basic “user journey” to results (further elaborated below) Slightly different data visualizations Envisioning an explicit link between UCSR and UCost (TBD) Envisioning separate download buttons in UCost for: Data Equations (for modelers)

UCost: Filtering Same options as UCSR: Disease Intervention Class Unit Country Population Parameter [cost driver] selection (results depend on econometrics): Platform Technology Ownership? Urbanicity? Scale? Note that the look will be redesigned in alignment with the UCSR. We just don’t have a mock-up yet according to the new UCSR design.

UCost: Initial display of results Filters will likely be at the top, as they are in the UCSR. First display panel has two sets of results Estimated unit cost (table + stacked bar chart) Distribution of unit cost (table + box plot) Lower panel could be a world map showing the range in cost. It is unclear yet if these displays would be in a separate section, as in the UCSR.

UCost: Other possible displays

Thank-you! Your feedback is welcomed. Please come to the reception at 5:00 for a beta-testing of the UCSR (and for drinks!). You may also test the UCSR at: https://ghcosting.org (under data) and send comments to: wdecormier@avenirhealth.org