tool is to provide a way to systematically and transparently establish rankings or comparisons among different intervention options across a broad range of criteria.

The following sections summarize the content of each of the presentations in this session. Chapter 6 provides a summary of the considerations raised in this session along with the presentations and discussions throughout the workshop.


Developing a Country-Validated Price Tag for Chronic Disease Prevention

Knowing how much it would cost to prevent or reduce noncommunicable diseases can be important for advocacy and to promote spending from international donors, Andrew Mirelman of Johns Hopkins University commented, as well as to establish priority setting at the national and subnational levels. He noted that efforts to calculate the costs of disease burdens and preventive interventions—for HIV/AIDS, vaccines, and child survival, for example—have become valuable tools for advocacy and for priority setting.

Mirelman described an effort to develop a disease prevention price tag using a cross-validation study in which international estimates of the costs of preventing specific diseases and reducing specific risk factors are compared with country-level data on costs for specific population- and individual-based interventions. The study explored prevention costs for noncommunicable diseases in 19 resource-poor countries and was carried out primarily by a number of Centers of Excellence set up through the UnitedHealth Chronic Disease Initiative and the U.S. National Heart, Lung, and Blood Institute (NHLBI).1 The Centers of Excellence are research institutions in low- and middle-income countries that collaborate with academic institutions in high-income countries in order to address chronic diseases. (See Box 4-1 for a list of the centers and their university partners at the time of Mirelman’s data collection.) The goal of the Centers of Excellence program is to build research capacity within local institutions, and for the past year these centers have participated in developing a country validation approach to calculating the costs of prevention.

For this project, the teams used values from international databases (including the World Health Organization [WHO] Comparative Risk Assessment for Burden of Disease, WHO-CHOICE reference pricing, the Management Sciences for Health International Drug Price Indicator Guide,


1 For more information see (accessed October 2011).

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