Health Economics TOT

Training of Trainers for Economic Evaluation in D2P

Program Overview

The Health Economics Training of Trainers (HE TOT) is specialized for health economists who will mentor D2P Unit 2 (Economic Evaluation). This intensive training strengthens skills in decision tree modeling, cost-effectiveness analysis, health economics modelling, and teaching these methods to non-economists.

🎯 Purpose

Unit 2 requires expertise in decision modeling, cost analysis, CEA methods, and health economics modelling to support evidence-based policy decisions.

⏱️ Duration

3-4 days intensive sessions with hands-on Excel workshops, practical modeling exercises, and teaching practice.

👥 Participants

8-15 health economists with formal training in health economics, public health economics, or related field.

📅 Format

Can be delivered nationally or regionally. Regional format enables cross-country learning and collaboration.

🌏 Regional Health Economics TOT

The CDC Foundation organizes regional 4-day Health Economics TOTs for Asian D4H focus countries to address critical health economics modelling capacity gaps.

Regional Approach Benefits

  • Expand Regional Pool: Build qualified health economists across multiple countries
  • Cross-Country Learning: Share experiences and approaches from different settings
  • Collaborative Networks: Foster ongoing regional collaboration and peer support
  • Efficient Capacity Building: Train multiple countries simultaneously

Target Countries

Asian D4H Focus Countries:

  • Thailand (~4 participants)
  • Bangladesh
  • Philippines
  • Vietnam
  • Other Asian D4H countries

Strategic Objectives

  • Address health economics modelling capacity gaps
  • Equip participants to integrate health economics into future D2P cohorts
  • Support evidence-based policy decisions throughout the region
  • Build sustainable regional expertise

Learning Objectives

1. Teach Economic Methods

Effectively deliver Unit 2 modules (L09-L13), making complex concepts accessible to non-economists in D2P settings

2. Guide Decision Trees

Support participants in building decision tree models that accurately represent health policy scenarios

3. Mentor Cost Analysis

Help teams develop comprehensive cost inventories and identify appropriate data sources in LMIC contexts

4. Conduct CEA

Guide through cost-effectiveness analysis, calculate ICERs, and interpret results for policy relevance

5. Health Economics Modelling

Apply advanced health economics modelling techniques appropriate for policy evaluation contexts

6. Troubleshoot Issues

Address typical data gaps, modeling challenges, and methodological questions that arise in D2P

4-Day Curriculum

Day 1: Fundamentals & D2P Context

Morning: D2P overview and Unit 2 role, economic evaluation review, teaching economics to non-economists, Unit 2 modules deep dive (L09-L13)

Afternoon: Module L09 (Framing Economic Evaluations) teaching practice, case study walkthrough (e.g., syphilis screening Tanzania), group discussions on framing challenges

Day 2: Decision Tree Modeling & Health Economics Modelling

Morning: Module L10 (Assessing Health Impact), decision tree components and structure, expected value calculations, discounting principles, Excel workshop Part 1

Afternoon: Advanced Excel workshop, health economics modelling techniques, D2P decision tree templates, common modeling mistakes, hands-on practice building models, peer review exercises

Day 3: Cost Analysis & Cost-Effectiveness

Morning: Module L11 (Cost Analysis), developing cost inventories (investment, recurrent, HR costs), finding cost data in LMIC settings, costing challenges and solutions

Afternoon: Module L12 (Economic Evaluation Methods), CEA, CUA, CBA comparison, calculating and interpreting ICERs, WHO thresholds and country-specific contexts, Excel integration workshop

Day 4: Sensitivity Analysis, Mentoring & Practice

Morning: Module L13 (Sensitivity Analysis), one-way and multi-way approaches, probabilistic methods when appropriate, tornado diagrams and visualization, Excel workshop

Afternoon: Mentoring economic evaluations in D2P, troubleshooting common issues, practice presentations of assigned modules, peer feedback sessions, action planning for upcoming D2P cohorts

Who Should Attend?

Required Qualifications

  • Advanced degree in health economics, economics, or related field (Master's minimum, PhD preferred)
  • Formal training in economic evaluation methods
  • Experience conducting CEA, CUA, or HTA
  • Proficiency in Excel and statistical software
  • Understanding of local health system context
  • Commitment to mentor D2P Unit 2

Ideal Candidate Profile

  • University faculty teaching health economics
  • HTA agency or health economics institute researcher
  • Ministry of Health staff with economics expertise
  • Consultant with extensive CEA experience
  • D2P graduate with economics background (helpful)
  • Regional collaborator interested in cross-country learning

Important Skills

  • Explain complex concepts in simple terms
  • Patience with learners new to economics
  • Strong troubleshooting and problem-solving
  • Teaching or mentoring experience
  • Flexibility adapting methods to data constraints
  • Cultural sensitivity for cross-country work

Key Technical Areas

💰 Costing Methods

Ingredients approach, top-down vs bottom-up, opportunity costs, shadow pricing, handling missing/unreliable data

📊 Decision Modeling

Structuring policy problems, defining pathways, probability assignment, time horizon selection, model validation

🔬 Health Economics Modelling

Advanced modeling techniques, parameter estimation, model calibration, validation approaches for policy contexts

📈 Health Outcomes

DALYs, QALYs, life years gained, disability weights, QALY adjustments, finding and validating outcome data

🔬 Analysis Methods

Incremental analysis (ICERs, ICURs), dominance and extended dominance, sensitivity analysis types, threshold analysis

🌍 LMIC Context

WHO-CHOICE methods adaptation, CE thresholds for LMICs, limited data strategies, regional proxies, budget impact vs CEA

🎓 Teaching Techniques

Breaking down complex concepts, effective visual aids, scaffolding from simple to complex, checking understanding

🌏 Regional Collaboration

Cross-country learning approaches, adapting methods to different contexts, building regional networks

Tools & Resources Provided

📊 Excel Templates

  • Decision Tree Builder (multiple versions)
  • Cost Inventory Workbook
  • CEA Calculator with ICER calculations
  • Sensitivity Analysis Tools
  • Budget Impact Analysis Template

📚 Reference Materials

  • WHO Guide to Cost-Effectiveness Analysis
  • Economic Evaluation Glossary
  • Discount Rate Guidelines by Country
  • CE Threshold Reference Tables
  • Unit Conversion Tables

📝 Teaching Materials

  • Unit 2 Module PowerPoints (L09-L13)
  • Case Studies (e.g., Syphilis, Diabetes)
  • Facilitator Notes for each module
  • Activity Sheets for participants
  • Assessment rubrics

🎯 Practice Examples

  • Motorcycle helmet policy (Tanzania)
  • HPV vaccination (Thailand)
  • Diabetes screening (South Africa)
  • Tobacco taxation (Multiple countries)
  • HIV testing scale-up (Rwanda)

Common Challenges & Solutions

🚧 Limited Cost Data

Solutions: Use proxy costs, adapt regional unit costs, conduct targeted data collection, document assumptions clearly, test through sensitivity analysis

🚧 Overly Complex Models

Solutions: Encourage simple transparent models, focus on key decision points, remember policy question over precision, use simplifying assumptions appropriately

🚧 Excel Challenges

Solutions: Provide step-by-step tutorials, offer pre-built templates, schedule dedicated help sessions, pair strong Excel users with struggling teams

🚧 Unrealistic Results

Solutions: Review all input parameters, check formula logic, validate against published studies, ensure probabilities sum to 1.0, face validity checks

Join the Health Economics TOT

Contact us to learn about upcoming HE TOT workshops, including regional trainings.