Using a simple checklist to prioritise medical devices in low-income countries and as a screening test for full health economic modelling
Many hospitals in low-income countries (LICs) have a long list of items that staff would like to procure.
However, there is insufficient time and resources available to conduct full costeffectiveness analysis of all items, while basic items, such as corner cabinets or syringes would be difficult to prioritise on the basis of a formal economic model.
A method is needed to identify items for procurement based on informal judgment, without a health economic evaluation.
The authors defined a screening algorithm with five decision-gates:
1) Plausibility – is the device a bare essential? i.e. simple devices that are easy to use, do not rely on continuous external power, have low relative cost, have widespread benefits, etc.
2) Usability – is the device usable? i.e. the physical infrastructure, human resources, and supply chain needed are available.
3) Cost minimisation – is a cheaper alternative available?
4) Cost -effectiveness Programme – is the device part of a multi -component service that has been shown to be cost -effective in LICs? e.g. devices that are a necessary component of a service tackling TB, such as a microscope.
5) Cost -effectiveness Analysis – is the device cost -effective? If there is not sufficient time or resources to construct a model, an intuitive decision should be made.