Using economic modelling to determine the optimal package of services against non-communicable diseases (NCDs) in South Africa (360G-Wellcome-218334_Z_19_Z)

The goal of this study is to use economic analysis and disease modelling to determine the economic impact of non-communicable diseases (NCDs) in South Africa and to establish how to optimally allocate public-sector resources across NCD interventions. Under this project I will construct a multi-disease health state transition model and use it to establish healthcare costs of and needs for different interventions (including preventative measures for distal risk factors such as smoking and alcohol intake) and packages of interventions targeted at the prevention, early detection and management of NCDs at baseline and over the next 20 years. Ingredients-based costing and micro-costing will be used to augment available data on intervention costs. Using an established epidemiological model parameterised to South Africa based on large surveys and routine data, I will then establish the incremental cost-effectiveness of individual interventions and intervention packages, allowing for downstream health benefits. Finally, I will test different combinations of interventions to identify the optimal package and service delivery platforms that will result in the most cost-effective programme to reach the country’s NCD policy goal, a reduction of premature mortality due to NCDs by 25%, under both the current budget and a budget increased by up to 50%.