Joep Lange Post-doctoral Fellow Profile: Uncovering the value of complex health interventions with a novel tool

The Joep Lange Chairs & Fellows Programme

Dr. Liv Nymark is a Joep Lange Post-doctoral Fellow at AIGHD. The Joep Lange Chair & Fellows Programme was established in 2015 in memory of the founder of AIGHD Prof. Joep Lange. Funded in part by the Dutch Ministry of Foreign Affairs, the programme was commissioned by the Joep Lange Institute. It is based at the Department of Global Health-Amsterdam Institute for Global Health and Development (AIGHD) at the Amsterdam UMC, University of Amsterdam.

Dr. Nymark works with Prof. Anna Vassall, Joep Lange Chair in health economics, to develop better tools to assess the cost-effectiveness of global health interventions against infectious diseases, such as TB Healthcare budgets are becoming increasingly constrained around the world which means that effective allocation of resources is more important than ever. Governments rely on economic evaluations to help guide their choice of policy by comparing the cost-effectiveness of different interventions.

Evaluating health interventions

Health economists seek to estimate the costs and benefits of healthcare interventions. Typically, the focus of measurement in economic evaluation is on the direct costs and benefits associated with an intervention. However, in the case of infectious diseases, there are also indirect effects which may influence the cost-effectiveness of complex interventions. In her current research, Dr. Nymark is trying to develop a checklist tool with a view to helping researchers ensure that they also include relevant indirect effects when assessing cost-effectiveness of complex interventions.

“If we want to avoid underestimating the value of a complex interventions, we must also estimate the cost and benefits of the indirect effects (also referred to as externalities by economists). I am currently working on a conceptual paper which considers different categories of externalities associated with infectious diseases. This will support the next steps in my research as the paper builds the framework from which the checklist will be derived. This will hopefully improve the way health economic evaluation is conducted,” she continued.

“Once these steps have been completed, a systematic review will follow. This is a review of previous economic evaluations of vaccines, malaria and tuberculosis. Here I will try to determine whether the researchers have included the categories of externalities as defined in the conceptual paper: and if so, how this was done. Finally, once we have tested the feasibility of the checklist tool in previous literature as a theoretical exercise, the tool will be tested in real-life settings in developing countries. It is complicated to perform cost effectiveness studies, so my goal is to make it easier for researchers to know when and how to include externalities in economic evaluation of complex interventions. Ultimately, using such a checklist should lead to more accurate studies which in turn will ensure that policymakers have better information when choosing between different health interventions.”

Interdisciplinary fellowship opportunity  

The benefits for Joep Lange Fellows are multifaceted: Dr. Nymark has the opportunity to work closely with her mentor and professor in health economics Prof. Vassall to develop her own research ideas within her field while also interacting with colleagues across other disciplines, such as medicine, epidemiology and anthropology.

The fellowship provides an opportunity to think across perspectives and disciplines which are traditionally juxtaposed but in practice intertwined. The fellowship is a recognition of the fact that challenges in global health require an interdisciplinary approach as providing isolated solutions to current issues in global health no longer is feasible.

Learn more about the Joep Lange Chair and Fellows Program.