1. iHEA Boston 2017 Congress,
Boston Massachusetts, USA
8-11 July 2017
Assessing the Quality of Voluntary Medical Male Circumcision Costing Literature
Session: Introducing a Reference Case for Costing Global Health Interventions
Benjamin Herzel, MS
Institute for Health Policy Studies
University of California, San Francisco
(on behalf of the GHCC)

2. Introduction
High-quality studies use appropriate methods and provide detailed reporting
Appropriate methods produce precise and replicable results
Detailed reporting allows results to be used for intended purpose and setting
Objective: To examine the methods used and the frequency of reporting in a comprehensive dataset extracted from Voluntary Medical Male Circumcision costing studies.

3. Search Strategy Used Cochrane Collaboration methods
HIV/AIDS term based on search filter developed by the Cochrane HIV/AIDS Group, used in >100 Cochrane reviews
Cost term based on the “best optimization of sensitivity & specificity” for econ studies
Developed by Wilczynski et al. (2004) and McKinlay et al. (2006)
Study dates from

4. VMMC Dataset 29 studies identified and extracted 759 cost observations
11 countries represented
Explain cost level

5. Reporting – Scope

6. Reporting – Sampling

7. Reporting – Methods (Cost Level)

8. Reporting – Inclusion of Costs

9. Reporting – Valuation

10. Reporting – Input Prices and Quantities

11. Economies of Scale

12. Compared by Subgroup

13. Methods – Type of Cost

14. Methods – Discount Rate

15. Methods – Above service costs

16. Methods – Timing

17. Methods – Sensitivity Analysis

18. Conclusions VMMC costing studies exhibit heterogeneous reporting
High-quality areas include costing purpose and inclusion/exclusion of overheads
Low-quality areas include sampling methods, allocation methods, cost sources, and input prices and quantities.
Methodological choices are varied, even in similar contexts (VMMC in SSA)

19. VMMC and TB studies compared
Similar findings:
Infrequent reporting on full vs. incremental and economic vs. financial costing
Very sparse reporting on sampling methods
Differences:
45% of VMMC studies report allocation method compared to approx. 4% of TB studies
VMMC studies much more likely to discuss or analyze scale effects (69% vs 35% in TB studies)

20. Next Steps
Developing similar datasets for all HIV interventions in LMICs.
Using data on reporting and methods to construct an empirically-validated quality-rating system