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NCD Module - Asthma Model

The repository for the WHO NCD Asthma Model.

Warning - These models are still being refined, and there may be changes to the methods, the interpretation of the methods, and the results.

General Notes on Modelling, Appendix 3, Notation, Nomenclature

Nomenclature and Formatting in this document

This documentation is referring to state transition models. State transition models have states, and transitions between those states. States have a name e.g. Healthy or Diseased or Deceased. When we talk about the number of people in a state, we will refer to the "stock" of a state, or the "balance" of a state. Sometimes, we might slip up and refer to a state as a node. These mean the same thing.

Transitions describe moving from one state (the "source state") to another state (the "target state"). We will write about specific transitions by noting the source state and the target state, separated by an arrow e.g. Healthy -> Diseased or Diseased -> Deceased. When we talk about the number of people moving between states (through a transition), we will refer to the "flow" between states. Sometimes, we might slip up and refer to a transition as an edge, or a link. These all mean the same thing.

Appendix 3 uses generalized - not incremental - cost-effectiveness

The results for Appendix 3 use "generalized cost-effectiveness" methods. The key result is "cost-effectiveness", which is just a measure of efficiency: how many dollars do you spend to get one unit of effect? In particular, we talk about dollars per DALY averted, or dollars per Healthy life year gained. When we talk about cost, we're talking about the difference in costs between two scenarios. Similarly, when we talk about effects, we're talking about the difference in effects between two scenarios. The first scenario is called the "Null Scenario". The second scenario is called the "Scale-up Scenario". The first scenario is hypothetical and pessimistic, and imagines a world where treatments for a specific disease didn't even exist. The second scenario is hypothetical and ambitious, and imagines a world where treatments for a specific disease reached nearly everyone who needed them. Therefore, the difference between these scenarios is intended to compare the best scenario (near universal coverage) with the worst scenario (complete absence of coverage), and tries to ignore the situation of "where a country is right now". This is very different from conventional "incremental cost-effectiveness" methods, which typically compare "where you are now", with "where you are now + a little bit more of an intervention". Therefore, comparing the results from Appendix 3 with other analyses is not advised. The results from Appendix 3 are intended to serve as general, high-level, normative guidance. Further analysis should occur at with the countries specific needs in mind.

Appendix 3 Key Assumptions

  • Start Year: 2019
  • End Year: 2119
  • Coverage Rate: 95%
  • Null Coverage Rate: 0%
  • Discounting on Effects? No
  • Discounting on Costs? Yes

Test Results

Country Scenario STATUS_CODE HYL Avenir HYL Ratio vs Baseline
AFG baseline 200 4,046,995,965 N/A N/A 1.000000
AFG null 200 4,046,649,103 5,746,845,568 0.704151 0.999914
AFG cr1 200 4,050,702,428 5,756,165,242 0.703715 1.000916
AFG cr3 200 4,049,533,018 5,757,584,300 0.703339 1.000627
DZA baseline 200 3,368,018,181 N/A N/A 1.000000
DZA null 200 3,367,744,744 5,282,705,433 0.637504 0.999919
DZA cr1 200 3,370,940,041 5,289,853,862 0.637246 1.000868
DZA cr3 200 3,370,018,178 5,289,502,889 0.637114 1.000594
AGO baseline 200 5,612,647,270 N/A N/A 1.000000
AGO null 200 5,612,167,158 11,995,863,380 0.467842 0.999914
AGO cr1 200 5,617,777,608 12,011,717,654 0.467691 1.000914
AGO cr3 200 5,616,158,957 12,010,594,493 0.467600 1.000626
ARG baseline 200 2,708,077,094 N/A N/A 1.000000
ARG null 200 2,707,712,309 4,452,751,487 0.608099 0.999865
ARG cr1 200 2,711,975,075 4,461,929,990 0.607803 1.001439
ARG cr3 200 2,710,745,239 4,459,677,972 0.607834 1.000985
BGD baseline 200 10,815,888,856 N/A N/A 1.000000
BGD null 200 10,815,335,333 13,804,999,091 0.783436 0.999949
BGD cr1 200 10,821,803,642 13,816,269,932 0.783265 1.000547
BGD cr3 200 10,819,937,493 13,818,660,023 0.782995 1.000374
BRA baseline 200 11,440,055,379 N/A N/A 1.000000
BRA null 200 11,439,019,520 15,651,983,832 0.730835 0.999909
BRA cr1 200 11,451,124,262 15,676,782,914 0.730451 1.000968
BRA cr3 200 11,447,631,966 15,671,770,414 0.730462 1.000662
BFA baseline 200 2,735,145,792 N/A N/A 1.000000
BFA null 200 2,734,957,927 5,430,433,168 0.503635 0.999931
BFA cr1 200 2,737,153,262 5,436,775,181 0.503452 1.000734
BFA cr3 200 2,736,519,894 5,436,619,317 0.503350 1.000502
BDI baseline 200 1,557,056,285 N/A N/A 1.000000
BDI null 200 1,556,892,677 3,321,070,031 0.468792 0.999895
BDI cr1 200 1,558,804,545 3,326,597,436 0.468588 1.001123
BDI cr3 200 1,558,252,959 3,326,491,400 0.468437 1.000769
CMR baseline 200 3,647,824,598 N/A N/A 1.000000
CMR null 200 3,647,592,351 6,020,563,963 0.605856 0.999936
CMR cr1 200 3,650,306,323 6,027,003,765 0.605659 1.000680
CMR cr3 200 3,649,523,324 6,027,127,258 0.605516 1.000466
CAF baseline 200 379,405,298 N/A N/A 1.000000
CAF null 200 379,374,243 835,216,891 0.454222 0.999918
CAF cr1 200 379,737,140 836,423,223 0.454001 1.000875
CAF cr3 200 379,632,442 836,678,764 0.453737 1.000599
TCD baseline 200 2,904,287,680 N/A N/A 1.000000
TCD null 200 2,904,121,392 4,120,352,575 0.704824 0.999943
TCD cr1 200 2,906,064,586 4,124,236,020 0.704631 1.000612
TCD cr3 200 2,905,503,962 4,124,888,015 0.704384 1.000419
CHN baseline 200 62,289,345,543 N/A N/A 1.000000
CHN null 200 62,286,597,153 103,265,039,347 0.603172 0.999956
CHN cr1 200 62,318,714,016 103,327,204,016 0.603120 1.000471
CHN cr3 200 62,309,448,095 103,317,562,079 0.603087 1.000323
COL baseline 200 3,599,450,731 N/A N/A 1.000000
COL null 200 3,599,214,129 4,072,425,647 0.883801 0.999934
COL cr1 200 3,601,978,986 4,077,076,666 0.883471 1.000702
COL cr3 200 3,601,181,307 4,076,037,419 0.883501 1.000481
COD baseline 200 16,563,686,863 N/A N/A 1.000000
COD null 200 16,562,412,697 24,783,819,263 0.668275 0.999923
COD cr1 200 16,577,302,214 24,816,220,818 0.668003 1.000822
COD cr3 200 16,573,006,493 24,818,219,635 0.667776 1.000563
CIV baseline 200 3,598,382,352 N/A N/A 1.000000
CIV null 200 3,598,094,310 6,147,760,587 0.585269 0.999920
CIV cr1 200 3,601,460,281 6,156,259,852 0.585008 1.000855
CIV cr3 200 3,600,489,177 6,155,693,329 0.584904 1.000585
DOM baseline 200 710,568,019 N/A N/A 1.000000
DOM null 200 710,508,773 1,024,823,192 0.693299 0.999917
DOM cr1 200 711,201,104 1,026,398,883 0.692909 1.000891
DOM cr3 200 711,001,362 1,026,334,646 0.692758 1.000610
ECU baseline 200 1,539,354,252 N/A N/A 1.000000
ECU null 200 1,539,320,585 1,890,182,812 0.814377 0.999978
ECU cr1 200 1,539,714,010 1,892,434,958 0.813615 1.000234
ECU cr3 200 1,539,600,505 1,891,920,598 0.813776 1.000160
EGY baseline 200 9,661,754,729 N/A N/A 1.000000
EGY null 200 9,660,904,708 16,528,980,175 0.584483 0.999912
EGY cr1 200 9,670,837,798 16,551,458,555 0.584289 1.000940
EGY cr3 200 9,667,972,038 16,551,561,502 0.584112 1.000643
ERI baseline 200 327,303,379 N/A N/A 1.000000
ERI null 200 327,265,646 668,987,691 0.489195 0.999885
ERI cr1 200 327,706,583 670,226,435 0.488949 1.001232
ERI cr3 200 327,579,370 670,188,369 0.488787 1.000843
ETH baseline 200 14,064,073,565 N/A N/A 1.000000
ETH null 200 14,062,966,718 20,275,772,539 0.693585 0.999921
ETH cr1 200 14,075,900,991 20,302,391,584 0.693312 1.000841
ETH cr3 200 14,072,169,371 20,301,258,803 0.693167 1.000576
GMB baseline 200 298,336,187 N/A N/A 1.000000
GMB null 200 298,313,181 588,697,055 0.506735 0.999923
GMB cr1 200 298,582,021 589,434,336 0.506557 1.000824
GMB cr3 200 298,504,459 589,446,105 0.506415 1.000564
GHA baseline 200 3,302,820,999 N/A N/A 1.000000
GHA null 200 3,302,628,196 5,495,004,236 0.601024 0.999942
GHA cr1 200 3,304,881,224 5,500,566,162 0.600826 1.000624
GHA cr3 200 3,304,231,211 5,501,088,323 0.600650 1.000427
GTM baseline 200 1,321,670,372 N/A N/A 1.000000
GTM null 200 1,321,599,001 2,406,305,921 0.549223 0.999946
GTM cr1 200 1,322,433,015 2,408,637,410 0.549038 1.000577
GTM cr3 200 1,322,192,397 2,408,426,258 0.548986 1.000395
GIN baseline 200 1,561,558,113 N/A N/A 1.000000
GIN null 200 1,561,418,562 3,014,393,070 0.517988 0.999911
GIN cr1 200 1,563,049,312 3,018,733,395 0.517783 1.000955
GIN cr3 200 1,562,578,830 3,018,982,366 0.517585 1.000654
GNB baseline 200 218,032,183 N/A N/A 1.000000
GNB null 200 218,014,560 390,953,526 0.557648 0.999919
GNB cr1 200 218,220,491 391,478,985 0.557426 1.000864
GNB cr3 200 218,161,079 391,536,405 0.557192 1.000591
HTI baseline 200 782,688,976 N/A N/A 1.000000
HTI null 200 782,583,399 1,255,625,000 0.623262 0.999865
HTI cr1 200 783,817,143 1,258,610,200 0.622764 1.001441
HTI cr3 200 783,461,200 1,258,657,457 0.622458 1.000987
IND baseline 200 87,699,483,307 N/A N/A 1.000000
IND null 200 87,690,987,542 122,416,930,341 0.716331 0.999903
IND cr1 200 87,790,266,501 122,570,031,216 0.716246 1.001035
IND cr3 200 87,761,623,886 122,600,956,789 0.715831 1.000709
IDN baseline 200 17,107,325,259 N/A N/A 1.000000
IDN null 200 17,105,863,676 26,331,873,196 0.649626 0.999915
IDN cr1 200 17,122,943,292 26,364,605,744 0.649467 1.000913
IDN cr3 200 17,118,015,714 26,369,887,267 0.649150 1.000625
IRN baseline 200 5,070,179,815 N/A N/A 1.000000
IRN null 200 5,069,686,505 8,042,722,928 0.630345 0.999903
IRN cr1 200 5,075,451,178 8,054,330,986 0.630152 1.001040
IRN cr3 200 5,073,788,033 8,053,020,572 0.630048 1.000712
IRQ baseline 200 4,592,144,933 N/A N/A 1.000000
IRQ null 200 4,591,791,680 7,630,776,801 0.601746 0.999923
IRQ cr1 200 4,595,919,693 7,640,579,987 0.601515 1.000822
IRQ cr3 200 4,594,728,735 7,639,232,123 0.601465 1.000563
JOR baseline 200 1,032,639,060 N/A N/A 1.000000
JOR null 200 1,032,537,972 1,137,073,571 0.908066 0.999902
JOR cr1 200 1,033,719,251 1,138,922,307 0.907629 1.001046
JOR cr3 200 1,033,378,444 1,138,559,336 0.907619 1.000716
KAZ baseline 200 1,554,849,222 N/A N/A 1.000000
KAZ null 200 1,554,792,778 2,202,583,424 0.705895 0.999964
KAZ cr1 200 1,555,452,368 2,203,945,371 0.705758 1.000388
KAZ cr3 200 1,555,262,072 2,204,144,717 0.705608 1.000266
KEN baseline 200 5,044,085,050 N/A N/A 1.000000
KEN null 200 5,043,692,455 8,960,939,967 0.562853 0.999922
KEN cr1 200 5,048,280,192 8,972,447,339 0.562642 1.000832
KEN cr3 200 5,046,956,600 8,972,485,769 0.562493 1.000569
MDG baseline 200 3,400,797,650 N/A N/A 1.000000
MDG null 200 3,400,315,727 6,341,573,089 0.536194 0.999858
MDG cr1 200 3,405,947,336 6,356,162,806 0.535850 1.001514
MDG cr3 200 3,404,322,581 6,355,663,112 0.535636 1.001037
MWI baseline 200 2,483,998,731 N/A N/A 1.000000
MWI null 200 2,483,761,969 4,391,726,283 0.565555 0.999905
MWI cr1 200 2,486,528,691 4,398,962,240 0.565253 1.001019
MWI cr3 200 2,485,730,474 4,398,330,764 0.565153 1.000697
MYS baseline 200 2,157,168,193 N/A N/A 1.000000
MYS null 200 2,157,033,701 2,996,480,087 0.719856 0.999938
MYS cr1 200 2,158,605,328 2,999,487,952 0.719658 1.000666
MYS cr3 200 2,158,151,904 2,999,322,983 0.719546 1.000456
MLI baseline 200 3,563,793,269 N/A N/A 1.000000
MLI null 200 3,563,598,727 5,698,182,358 0.625392 0.999945
MLI cr1 200 3,565,872,089 5,703,586,787 0.625198 1.000583
MLI cr3 200 3,565,216,210 5,704,877,028 0.624942 1.000399
MEX baseline 200 7,669,934,312 N/A N/A 1.000000
MEX null 200 7,669,544,971 12,043,981,319 0.636795 0.999949
MEX cr1 200 7,674,094,692 12,054,822,105 0.636600 1.000542
MEX cr3 200 7,672,782,068 12,053,084,940 0.636582 1.000371
MAR baseline 200 2,412,985,810 N/A N/A 1.000000
MAR null 200 2,412,801,163 3,707,365,575 0.650813 0.999923
MAR cr1 200 2,414,958,892 3,712,186,445 0.650549 1.000818
MAR cr3 200 2,414,336,373 3,712,699,982 0.650291 1.000560
MOZ baseline 200 4,315,473,666 N/A N/A 1.000000
MOZ null 200 4,314,997,903 8,293,344,757 0.520296 0.999890
MOZ cr1 200 4,320,557,532 8,307,911,842 0.520053 1.001178
MOZ cr3 200 4,318,953,543 8,306,479,670 0.519950 1.000806
MMR baseline 200 3,207,177,781 N/A N/A 1.000000
MMR null 200 3,207,004,927 4,891,606,405 0.655614 0.999946
MMR cr1 200 3,209,024,853 4,895,498,142 0.655505 1.000576
MMR cr3 200 3,208,442,091 4,898,356,118 0.655004 1.000394
NPL baseline 200 3,532,681,958 N/A N/A 1.000000
NPL null 200 3,532,573,700 2,343,193,428 1.507589 0.999969
NPL cr1 200 3,533,838,781 2,344,474,119 1.507306 1.000327
NPL cr3 200 3,533,473,797 2,346,261,389 1.506002 1.000224
NER baseline 200 5,917,479,237 N/A N/A 1.000000
NER null 200 5,917,088,944 11,378,739,162 0.520013 0.999934
NER cr1 200 5,921,649,792 11,391,353,955 0.519837 1.000705
NER cr3 200 5,920,333,958 11,391,804,334 0.519701 1.000482
NGA baseline 200 25,407,630,676 N/A N/A 1.000000
NGA null 200 25,405,129,050 48,790,717,826 0.520696 0.999902
NGA cr1 200 25,434,362,295 48,863,253,029 0.520521 1.001052
NGA cr3 200 25,425,928,317 48,852,677,766 0.520461 1.000720
PAK baseline 200 21,730,354,167 N/A N/A 1.000000
PAK null 200 21,729,439,265 31,507,254,255 0.689665 0.999958
PAK cr1 200 21,740,130,526 31,530,385,035 0.689498 1.000450
PAK cr3 200 21,737,046,029 31,537,257,076 0.689250 1.000308
PER baseline 200 2,961,911,838 N/A N/A 1.000000
PER null 200 2,961,839,967 3,152,924,313 0.939395 0.999976
PER cr1 200 2,962,679,834 3,156,976,639 0.938455 1.000259
PER cr3 200 2,962,437,527 3,156,063,324 0.938650 1.000177
PHL baseline 200 9,027,401,673 N/A N/A 1.000000
PHL null 200 9,026,559,178 12,233,456,665 0.737858 0.999907
PHL cr1 200 9,036,404,321 12,252,283,273 0.737528 1.000997
PHL cr3 200 9,033,563,934 12,255,087,516 0.737128 1.000683
RUS baseline 200 7,255,524,941 N/A N/A 1.000000
RUS null 200 7,255,121,527 10,124,961,536 0.716558 0.999944
RUS cr1 200 7,259,835,707 10,133,302,575 0.716433 1.000594
RUS cr3 200 7,258,475,636 10,131,614,533 0.716418 1.000407
RWA baseline 200 1,445,830,357 N/A N/A 1.000000
RWA null 200 1,445,553,990 2,529,279,295 0.571528 0.999809
RWA cr1 200 1,448,783,530 2,537,129,677 0.571033 1.002043
RWA cr3 200 1,447,851,787 2,535,926,440 0.570936 1.001398
SLE baseline 200 852,825,097 N/A N/A 1.000000
SLE null 200 852,759,841 1,180,305,487 0.722491 0.999923
SLE cr1 200 853,522,405 1,181,799,410 0.722223 1.000818
SLE cr3 200 853,302,400 1,181,877,630 0.721989 1.000560
ZAF baseline 200 3,869,865,289 N/A N/A 1.000000
ZAF null 200 3,869,475,406 6,036,885,836 0.640972 0.999899
ZAF cr1 200 3,874,031,467 6,046,379,265 0.640719 1.001077
ZAF cr3 200 3,872,717,014 6,045,828,681 0.640560 1.000737
LKA baseline 200 1,080,963,101 N/A N/A 1.000000
LKA null 200 1,080,838,577 1,738,915,382 0.621559 0.999885
LKA cr1 200 1,082,293,731 1,741,786,609 0.621370 1.001231
LKA cr3 200 1,081,873,910 1,742,752,838 0.620784 1.000843
SDN baseline 200 5,893,395,524 N/A N/A 1.000000
SDN null 200 5,892,754,608 9,336,501,431 0.631152 0.999891
SDN cr1 200 5,900,244,154 9,352,908,023 0.630846 1.001162
SDN cr3 200 5,898,083,372 9,351,251,423 0.630727 1.000795
TJK baseline 200 1,034,856,961 N/A N/A 1.000000
TJK null 200 1,034,801,226 1,993,430,404 0.519106 0.999946
TJK cr1 200 1,035,452,527 1,994,962,901 0.519033 1.000576
TJK cr3 200 1,035,264,623 1,994,795,360 0.518983 1.000394
TZA baseline 200 9,521,010,320 N/A N/A 1.000000
TZA null 200 9,519,681,359 18,209,286,561 0.522793 0.999860
TZA cr1 200 9,535,211,193 18,249,557,854 0.522490 1.001492
TZA cr3 200 9,530,730,737 18,242,552,326 0.522445 1.001021
THA baseline 200 3,067,185,419 N/A N/A 1.000000
THA null 200 3,066,882,603 4,260,264,620 0.719881 0.999901
THA cr1 200 3,070,421,219 4,266,231,588 0.719703 1.001055
THA cr3 200 3,069,400,306 4,265,653,989 0.719561 1.000722
TGO baseline 200 1,123,419,859 N/A N/A 1.000000
TGO null 200 1,123,316,323 1,770,308,347 0.634531 0.999908
TGO cr1 200 1,124,526,208 1,773,013,962 0.634246 1.000985
TGO cr3 200 1,124,177,149 1,772,888,681 0.634093 1.000674
TUR baseline 200 4,927,847,481 N/A N/A 1.000000
TUR null 200 4,927,052,587 7,324,246,528 0.672704 0.999839
TUR cr1 200 4,936,341,488 7,341,861,996 0.672356 1.001724
TUR cr3 200 4,933,661,580 7,338,062,990 0.672338 1.001180
UGA baseline 200 6,138,075,318 N/A N/A 1.000000
UGA null 200 6,137,289,716 9,588,131,151 0.640092 0.999872
UGA cr1 200 6,146,470,028 9,606,879,268 0.639799 1.001368
UGA cr3 200 6,143,821,449 9,604,916,709 0.639654 1.000936
UKR baseline 200 1,681,295,771 N/A N/A 1.000000
UKR null 200 1,681,179,740 2,447,156,327 0.686993 0.999931
UKR cr1 200 1,682,535,645 2,449,558,435 0.686873 1.000737
UKR cr3 200 1,682,144,458 2,449,002,290 0.686869 1.000505
UZB baseline 200 2,560,080,634 N/A N/A 1.000000
UZB null 200 2,559,881,521 3,636,064,115 0.704025 0.999922
UZB cr1 200 2,562,208,302 3,640,388,998 0.703828 1.000831
UZB cr3 200 2,561,537,010 3,640,111,782 0.703697 1.000569
VNM baseline 200 5,759,677,097 N/A N/A 1.000000
VNM null 200 5,759,141,304 8,430,598,108 0.683124 0.999907
VNM cr1 200 5,765,402,422 8,441,449,560 0.682987 1.000994
VNM cr3 200 5,763,596,049 8,441,235,858 0.682791 1.000680