Stephane Verguet is Assistant Professor of Global Health at the Harvard T.H. Chan School of Public Health. Dr. Verguet's multidisciplinary research focuses on health decision science and priority setting, particularly the development of mathematical and computational decision-making models to better design health policies. His research interests include health economics, cost-effectiveness analysis, equity, and health systems performance. Most recently, he has been working on the estimation of non-health benefits, particularly the poverty alleviation benefits, of health policies and interventions.
Research areas and projects
Methods: Extended cost-effectiveness analysis (ECEA).
I have co-led the development of the methodology of "extended cost-effectiveness analysis" (ECEA), which attempts to incorporate the distributional, equity and poverty reduction benefits of policies into traditional economic evaluation methods. ECEA methods have now been widely used as the key economic methodology for the Disease Control Priorities, 3rd edition (www.dcp-3.org).
• Verguet S, Laxminarayan R, Jamison DT. Universal public finance of tuberculosis treatment in India: an extended cost-effectiveness analysis. Health Economics 2015; 24(3):318-332.
• Verguet S, Olson Z, Babigumira J, Desalegn D, Johansson KA, Kruk ME, Levin CE, Nugent RA, Pecenka C, Shrime MG, Tessema Memirie S, Watkins DA, Jamison DT. Health gains and financial risk protection afforded from public financing of selected interventions in Ethiopia: an extended cost-effectiveness analysis. Lancet Global Health 2015; 3:e288-296.
• Verguet S, Kim JJ, Jamison DT. Extended cost-effectiveness analysis for health policy assessment: a tutorial PharmacoEconomics 2016; 24(3):318-332.
Example of applications: equity and poverty alleviation benefits of vaccines.
To estimate the equity and poverty reduction benefits of vaccines in low- and middle-income countries, and to pursue a set of corresponding extended cost-effectiveness analysis economic evaluations.
• Verguet S, Murphy S, Anderson B, Johansson KA, Glass R, Rheingans R. Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis. Vaccine 2013; 31(42):4902-4910.
• Driessen JR, Olson ZD, Jamison DT, Verguet S. Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: an extended cost-effectiveness analysis. Social Science and Medicine 2015; 139:115-122.
Disease Control Priorities - Ethiopia (DCP-E)
DCP-E intends to bring evidence and methods of priority setting and health economics closer to policy decision-making in Ethiopia. To achieve this purpose, three objectives are important:
1. To develop health economic evaluation and priority setting capacity in Ethiopia.
2. To provide input, through research and evidence, to the revision of the essential health care package for Ethiopia.
3. To establish a process to support health priority setting in Ethiopia, including assessing the cost-effectiveness of selected health sector interventions, packages, and delivery platforms.
• Memirie ST, Verguet S, Norheim OF, Levin C, Johansson KA. Inequalities in utilization of maternal and child health services in Ethiopia: the role of primary health care. BMC Health Services Research 2016.
• Tolla MT, Norheim OF, Memirie ST, Abdisa SG, Ababulgu A, Jerene D, Bertram M, Strand K, Verguet S, Johansson KA. Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis. Cost Effectiveness and Resource Allocation 2016.
• Verguet S, Memirie ST, Norheim OF. Assessing the burden of medical impoverishment by cause: a systematic breakdown by disease in Ethiopia. BMC Medicine 2016.
Big data and health system modeling
I study health system performance and country performance on health through a quantitative lens that draws on a set of innovative approaches. In particular, we use mathematical and computational frameworks from physics and systems engineering to design dynamic models that replicate health system behaviors in real life, and, envision new potential relationships between the basic building blocks of health delivery in low- and middle-income countries. This includes the examination of trends in the evolution of health indicators over time, the study of the integration and the potential positive/negative synergies of certain delivery platforms with other health services, and the health systems more broadly.
• Verguet S, Jamison DT. Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970-2010. Health Policy and Planning 2014; 29(2):151.
• Verguet S, Norheim OF, Olson ZD, Yamey G, Jamison DT. Performance in reducing child, maternal, HIV and tuberculosis mortality rates across 109 low- and middle-income countries from 1990-2013. Lancet Global Health 2014; 2:e698-709.
• Verguet S, Jassat W, Bertram MY, Tollman S, Murray CJL, Jamison DT, Hofman KJ. Impact of supplementary immunization activities (SIAs) on health systems: findings from South Africa. Journal of Epidemiology and Community Health 2013; 67:947-952. http://jech.bmj.com/content/67/11/947.short
I have designed decision-making models including a range of mathematical techniques (e.g. analytical functions, differential equations, optimization) in order to address a variety of problems in global public health, such as infectious disease transmission, resource allocation questions, and demographic modeling.
• Verguet S, Johri M, Morris S, Gauvreau C, Jha P, Jit M. Controling measles using supplemental immunization activities: a mathematical model to inform optimal policy. Vaccine 2015; 33:1291.
• Verguet S, Lim SS, Murray CJL, Gakidou E, Salomon JA. Incorporating loss to follow-up in estimates of survival among HIV-infected individuals in sub-Saharan Africa enrolled in antiretroviral therapy programs. Journal of Infectious Diseases 2013; 207(1):72.
• Verguet S. Efficient and equitable HIV prevention: a case study of male circumcision in South Africa. Cost Effectiveness and Resource Allocation 2013; 11:1.
On the question of how to expand tobacco control, favored tactics include increased excise taxes on tobacco products, and the expansion and enforcement of smoke-free zones. I have been working to evaluate the distributional consequences of these approaches (across socio-economic groups and geographical settings) in terms of health benefits, equity and poverty reduction benefits to households.
• Verguet S, Gauvreau C, Mishra S, MacLennan M, Murphy S, Brouwer E, Nugent RA, Zhao K, Jha P, Jamison DT. The consequences of tobacco tax on household health and finances in rich and poor smokers in China: an extended cost-effectiveness analysis. Lancet Global Health 2015; 3:e206.
• Salti N, Brouwer ED, Verguet S. The health, financial and distributional consequences of increases in the tobacco excise tax among smokers in Lebanon. Social Science and Medicine 2016; 170:161-169.