Hossein Hajiali Afzali

School of Public Health

Faculty of Health and Medical Sciences

I am a Senior Research Fellow (health economics) with expertise in the economic evaluation of health technologies with a focus on the application of decision analytic modelling techniques. I am also a medical doctor (MD) and received my medical degree from Tehran University of Medical Sciences.

I am a member of the Evaluation Sub-Committee (ESC) of the Medical Services Advisory Committee (MSAC) whose role is to advise the Australian government on evidence relating to the safety, effectiveness and cost-effectiveness of new medical technologies and procedures. In addition, I am involved in a number of research projects aiming to improve the decision making process around the funding of health technologies.

Previously I was an evaluator of submissions to the Pharmaceutical Benefits Advisory Committee (PBAC) to determine funding of medicines. I also co-lead the Adelaide Health Economics Research Group with expertise in all components of the economic evaluation of health care interventions.

My Research
Career
Publications
Grants and Funding
Teaching
Supervision
Professional Activities
Contact

Research Interests

Economic evaluation of health technologies
Decision analytic modelling for health economic evaluation
Improving public funding decision processes

Appointments

Date	Position	Institution name
2017 - ongoing	Senior Lecturer (Health Economics)	University of Adelaide, Adelaide
2012 - 2016	Senior Research Fellow (Health Economics)	University of Adelaide
2009 - 2011	Research Fellow (Health Economics)	University of Adelaide
2007 - 2009	Senior Research Officer	University of Adelaide
2000 - 2002	Head (Abourayhan Medical Centre)	The Iranian Social Security Organization
1995 - 2000	General Practitioner	The Iranian Social Security Organization

Education

Date	Institution name	Country	Title
2004 - 2007	University of Adelaide	Australia	PhD in Health Economics
2003 - 2004	University of Adelaide	Australia	Graduate Diploma in Public Health
1987 - 1995	University of Tehran	Iran	Doctor of Medicine (MD)

Journals

Year	Citation
2023	Best, K. P., Gould, J. F., Makrides, M., Sullivan, T., Cheong, J., Zhou, S. J., . . . Green, T. (2023). Prenatal iodine supplementation and early childhood neurodevelopment: the PoppiE trial - study protocol for a multicentre randomised controlled trial. BMJ Open, 13(5), e071359-1-e071359-8. DOI Scopus1 Europe PMC1
2023	Pincombe, A., Afzali, H. H. A., Visvanathan, R., & Karnon, J. (2023). Development and validation of an individual-based state-transition model for the prediction of frailty and frailty-related events. PloS one, 18(8), 1-18. DOI
2023	Merlin, T., Street, J., Carter, D., & Haji Ali Afzali, H. (2023). Challenges in the Evaluation of Emerging Highly Specialised Technologies: Is There a Role for Living HTA?. Applied Health Economics and Health Policy, 21(6), 823-830. DOI Scopus1
2023	Hossain, S., Moeller, H., Sharpe, P., Campbell, M., Kimlin, R., Porykali, B., . . . Ryder, C. (2023). Characterising the Aboriginal and Torres Strait Islander patient journey after a serious road traffic injury and barriers to access to compensation: a protocol. Injury Prevention, 30(1), 75-80. DOI
2022	Karnon, J., Partington, A., & Afzali, H. (2022). Strategies for Avoiding Neglect of Opportunity Costs by Decision-Makers. Applied Health Economics and Health Policy, 20(1), 9-11. DOI
2022	Karnon, J., Afzali, H. H. A., & Bonevski, B. (2022). An Economic Evaluation of Government-Funded COVID-19 Testing in Australia. Applied Health Economics and Health Policy, 20(5), 681-691. DOI Scopus1
2021	Haji Ali Afzali, H., Street, J., Merlin, T., & Karnon, J. (2021). The representation of public values in health technology assessment to inform funding decisions: The case of Australia's national funding bodies. International Journal of Technology Assessment in Health Care, 37(1), 1-4. DOI Scopus5 WoS3 Europe PMC2
2021	Jadczak, A. D., Robson, L., Cooper, T., Bell, J. S., & Visvanathan, R. (2021). The Frailty In Residential Sector over Time (FIRST) study: methods and baseline cohort description. BMC Geriatrics, 21(1), 99-1-99-12. DOI Scopus19 WoS15 Europe PMC9
2021	Wilkin, R., Clouston, H., Coe, P., Duarte, R., Stott, M., Pockney, P., . . . Waite, K. (2021). An international pragmatic randomized controlled trial to compare a single-use negative-pressure dressing versus the surgeon’s preference of dressing to reduce the incidence of surgical site infection following emergency laparotomy: the SUNRRISE trial protocol. Colorectal Disease, 23(4), 989-1000. DOI Scopus5 WoS5 Europe PMC1
2019	Marshall, H., McMillan, M., Wang, B., Booy, R., Afzali, H., Buttery, J., . . . Barton, B. (2019). AMEND study protocol: a case-control study to assess the long-term impact of invasive meningococcal disease in Australian adolescents and young adults.. BMJ Open, 9(12), e032583. DOI Scopus3 WoS3 Europe PMC2
2019	Edney, L., Haji Ali Afzali, H., & Karnon, J. (2019). Are the benefits of new health services greater than their opportunity costs?. Australian Health Review, 43(5), 508-510. DOI Scopus2 WoS3
2019	Wang, B., Santoreneos, R., Giles, L., Haji Ali Afzali, H., & Marshall, H. (2019). Case fatality rates of invasive meningococcal disease by serogroup and age: a systematic review and meta-analysis. Vaccine, 37(21), 2768-2782. DOI Scopus123 WoS102 Europe PMC67
2019	Haji Ali Afzali, H., Bojke, L., & Karnon, J. (2019). Improving decision-making processes in health: is it time for (disease-specific) reference models?. Applied Health Economics and Health Policy, 18(1), 1-4. DOI Scopus4 WoS4 Europe PMC2
2019	Afzali, H. H. A., Karnon, J., Theou, O., Beilby, J., Cesari, M., & Visvanathan, R. (2019). Structuring a conceptual model for cost effectiveness analysis of frailty interventions. PLoS ONE, 14(9), e0222049. DOI Scopus10 WoS8 Europe PMC7
2019	Wang, B., Hajiali Afzali, H., Giles, L., & Marshall, H. (2019). Lifetime costs of invasive meningococcal disease: a Markov model approach. Vaccine, 37(46), 6885-6893. DOI Scopus4 WoS2 Europe PMC4
2018	Kim, C., Kim, J., Marshall, R., & Afzali, H. (2018). Stakeholder influence, institutional duality, and CSR involvement of MNC subsidiaries. Journal of Business Research, 91, 40-47. DOI Scopus54
2018	Edney, L., Haji Ali Afzali, H., Cheng, T., & Karnon, J. (2018). Estimating the reference incremental cost-effectiveness ratio for the Australian health system. PharmacoEconomics, 36(2), 239-252. DOI Scopus154 WoS130 Europe PMC79
2018	Karnon, J., Edney, L., & Afzali, H. (2018). The political economy of the assessment of value of new health technologies. Journal of Health Services Research and Policy, 23(2), 116-122. DOI Scopus5 WoS4 Europe PMC1
2018	Lambert, R., Carter, D. A., Burgess, N., & Hajiali Afzali, H. (2018). The development of funding recommendations for health technologies at the state level: a South Australian case study. The International Journal of Health Planning and Management, 33(4), 806-822. DOI Scopus1 WoS1
2018	Edney, L., Haji Ali Afzali, H., Cheng, T., & Karnon, J. (2018). Mortality reductions from marginal increases in public spending on health. Health Policy, 122(8), 892-899. DOI Scopus16 WoS13 Europe PMC7
2018	Wang, B., Santoreneos, R., Afzali, H., Giles, L., & Marshall, H. (2018). Costs of invasive meningococcal disease: a global systematic review. PharmacoEconomics, 36(10), 1201-1222. DOI Scopus20 WoS16 Europe PMC15
2018	Haji Ali Afzali, H., Bojke, L., & Karnon, J. (2018). Model structuring for economic evaluations of new health technologies. PharmacoEconomics, 36(11), 1309-1319. DOI Scopus13 WoS12 Europe PMC7
2017	Karnon, J., Afzali, H., Putro, G., Thant, P., Dompok, A., Cox, I., . . . Cameron, I. (2017). A cost-effectiveness model for frail older persons: development and application to a physiotherapy-based intervention. Applied Health Economics and Health Policy, 15(5), 635-645. DOI Scopus9 WoS8 Europe PMC4
2017	Gray, J., Hoon, E., Hajiali Afzali, H., Spooner, C., Harris, M. F., & Karnon, J. (2017). Is the Counterweight Program a feasible and acceptable option for structured weight management delivered by practice nurses in Australia? A mixed methods study. Australian Journal of Primary Health, 23(4), 348-363. DOI Scopus4 WoS3 Europe PMC1
2017	Wang, B., Chen, G., Ratcliffe, J., Afzali, H., Giles, L., & Marshall, H. (2017). Adolescent values for immunisation programs in Australia: a discrete choice experiment. PLoS ONE, 12(7), e0181073-1-e0181073-14. DOI Scopus19 WoS16 Europe PMC15
2017	Karnon, J., & Afzali, H. H. (2017). Predictive Validation and the Re-Analysis of Cost-Effectiveness: Do We Dare to Tread?. PharmacoEconomics, 35(11), 1111-1112. DOI Scopus1 WoS1 Europe PMC1
2016	Wang, B., Giles, L., Afzali, H., Clarke, M., Ratcliffe, J., Chen, G., & Marshall, H. (2016). Adolescent confidence in immunisation: assessing and comparing attitudes of adolescents and adults. Vaccine, 34(46), 5595-5603. DOI Scopus13 WoS12 Europe PMC8
2016	Carter, D. A., Vogan, A., & Haji Ali Afzali, H. (2016). Governments need better guidance to maximise value for money: the case of Australia’s Pharmaceutical Benefits Advisory Committee. Applied Health Economics and Health Policy, 14(4), 401-407. DOI Scopus14 WoS11 Europe PMC5
2016	Haji Ali Afzali, H., Karnon, J., & Sculpher, M. (2016). Should the Lambda (λ) Remain Silent?. PharmacoEconomics, 34(4), 323-329. DOI Scopus8 WoS7 Europe PMC5
2015	Haji Ali Afzali, H., & Karnon, J. (2015). Exploring structural uncertainty in model-based economic evaluations. PharmacoEconomics, 33(5), 435-443. DOI Scopus21 WoS17 Europe PMC11
2015	Frederix, G. W. J., Haji Ali Afzali, H., Dasbach, E. J., & Ward, R. L. (2015). Development and Use of Disease-Specific (Reference) Models for Economic Evaluations of Health Technologies: An Overview of Key Issues and Potential Solutions. PharmacoEconomics, 33(8), 777-781. DOI Scopus8 WoS7 Europe PMC4
2014	Karnon, J., & Haji Ali Afzali, H. (2014). When to use Discrete Event Simulation (DES) for the economic evaluation of health technologies? A review and critique of the costs and benefits of DES. PharmacoEconomics, 32(6), 547-558. DOI Scopus55 WoS44 Europe PMC26
2014	Afzali, H., Karnon, J., Beilby, J., Gray, J., Holton, C., & Banham, D. (2014). Practice nurse involvement in general practice clinical care: policy and funding issues need resolution. Australian Health Review, 38(3), 301-305. DOI Scopus18 WoS17 Europe PMC10
2014	Wang, B., Clarke, M., Thomas, N., Howell, S., Afzali, H., & Marshall, H. (2014). The clinical burden and predictors of sequelae following invasive meningococcal disease in Australian children. Pediatric Infectious Disease Journal, 33(3), 316-318. DOI Scopus21 WoS24 Europe PMC12
2014	Gray, J., Haji Ali Afzali, H., Beilby, J., Holton, C., Banham, D., & Karnon, J. (2014). Practice nurse involvement in primary care depression management: an observational cost-effectiveness analysis. BMC Family Practice, 15(10), 10-1-10-11. DOI Scopus4 WoS4 Europe PMC1
2014	Wang, B., Haji Ali Afzali, H., & Marshall, H. (2014). The inpatient costs and hospital service use associated with invasive meningococcal disease in South Australian children. Vaccine, 32(37), 4791-4798. DOI Scopus30 WoS23 Europe PMC18
2014	Wang, B., Clarke, M., Hajiali Afzali, H., & Marshall, H. (2014). Community, parental and adolescent awareness and knowledge of meningococcal disease. Vaccine, 32(18), 2042-2049. DOI Scopus22 WoS18 Europe PMC18
2013	Hajiali Afzali, H., Gray, J., Beilby, J., Holton, C., & Karnon, J. (2013). A model-based economic evaluation of improved primary care management of patients with type 2 diabetes in Australia. Applied Health Economics and Health Policy, 11(6), 661-670. DOI Scopus6 WoS7 Europe PMC4
2013	Carter, D., Hajiali Afzali, H., Street, J., Bessen, T., & Neuhaus, S. (2013). Melanoma follow up: time to generate the evidence. Australian Health Review, 37(4), 501-503. DOI WoS1 Europe PMC1
2013	Hajiali Afzali, H., Gray, J., Beilby, J., Holton, C., Banham, D., & Karnon, J. (2013). A risk-adjusted economic evaluation of alternative models of involvement of practice nurses in management of type 2 diabetes. Diabetic Medicine, 30(7), 855-863. DOI Scopus9 WoS9 Europe PMC7
2013	Hajiali Afzali, H., Gray, J., & Karnon, J. (2013). Model performance evaluation (validation and calibration) in model-based studies of therapeutic interventions for cardiovascular diseases: A review and suggested reporting framework. Applied Health Economics and Health Policy, 11(2), 85-93. DOI Scopus17 WoS17 Europe PMC14
2013	Karnon, J., Hajiali Afzali, H., Gray, J., Holton, C., Banham, D., & Beilby, J. (2013). A risk adjusted cost-effectiveness analysis of alternative models of nurse involvement in obesity management in primary care. Obesity, 21(3), 472-479. DOI Scopus11 WoS10 Europe PMC8
2013	Hajiali Afzali, H., Karnon, J., & Merlin, T. (2013). Improving the accuracy and comparability of model-based economic evaluations of health technologies for reimbursement decisions: a methodological framework for the development of reference models. Medical Decision Making, 33(3), 325-332. DOI Scopus27 WoS26 Europe PMC20
2012	Hajiali Afzali, H., Karnon, J., Gray, J., & Beilby, J. (2012). A model-based evaluation of collaborative care in management of patients with type 2 diabetes in Australia: an initial report. Australian Health Review, 36(3), 258-263. DOI Scopus3 WoS4 Europe PMC3
2012	Hajiali Afzali, H., Karnon, J., & Gray, J. (2012). A critical review of model-based economic studies of depression: modelling techniques, model structure and data sources. Pharmacoeconomics, 30(6), 461-482. DOI Scopus26 WoS20 Europe PMC14
2012	Hajiali Afzali, H., Karnon, J., & Gray, J. (2012). A proposed model for economic evaluations of major depressive disorder. European Journal of Health Economics, 13(4), 501-510. DOI Scopus15 WoS13 Europe PMC10
2012	Hajiali Afzali, H., Karnon, J., Gray, J., & Beilby, J. (2012). Evaluation of collaborative models of care in the management of patients with depression: protocol and progress. Mental Health in Family Medicine, 9(2), 91-97. Scopus1
2011	Hajiali Afzali, H., Moss, J., & Mahmood, M. (2011). Exploring health professionals' perspectives on factors affecting Iranian hospital efficiency and suggestions for improvement. International Journal of Health Planning and Management, 26(1), E17-E29. DOI Scopus6 WoS6 Europe PMC5
2011	Haji Ali Afzali, H., & Karnon, J. (2011). Addressing the challenge for well informed and consistent reimbursement decisions: The case for reference models. PharmacoEconomics, 29(10), 823-825. DOI Scopus16 WoS13 Europe PMC13
2009	Hajiali Afzali, H., Moss, J., & Mahmood, M. (2009). A conceptual framework for selecting the most appropriate variables for measuring hospital efficiency with a focus on Iranian public hospitals. Health Services Management Research, 22(2), 81-91. DOI Scopus18 WoS14 Europe PMC14
2007	Hajiali Afzali, H., Moss, J., & Mahmood, M. (2007). Efficiency measurement for hospitals owned by the Iranian Social Security organisation. Journal of Medical Systems, 31(3), 166-172. DOI Scopus41 WoS28 Europe PMC18

Book Chapters

Year	Citation
2014	Haji Ali Afzali, H., & Karnon, J. (2014). Specification and implementation of decision analytic model structures for the economic evaluation of health care technologies. In A. J. Culyer (Ed.), Encyclopedia of Health Economics (1st ed., pp. 340-347). Elsevier. DOI Scopus6

Conference Papers

Year	Citation
2017	Edney, L. C., Afzali, H. A. H., Cheng, T., & Kamon, J. (2017). ESTIMATING THE REFERENCE ICER FOR AUSTRALIA AND PUBLIC PERCEPTIONS TOWARD ITS USE. In VALUE IN HEALTH Vol. 20 (pp. A685). ELSEVIER SCIENCE INC. DOI

Conference Items

Year	Citation
2015	Gray, J. P., Hajiali Afzali, H., Harris, M., Spooner, C., & Karnon, J. (2015). Countering weight gain in general practice [Plenary presentation]. Poster session presented at the meeting of COMPaRE-PHC forum on obesity prevention and management in primary health care. Sydney, Australia.
2015	Gray, J. P., Hajiali Afzali, H., Harris, M., Spooner, C., Hunter-Riviere, V., Ross, H., . . . Karnon, J. (2015). Weight management in general practice: Piloting the Counterweight Program in Australia. Poster session presented at the meeting of Population Health Congress. Hobart, Australia.
2015	Gray, J. P., Hunter-Riviere, V., Hajiali Afzali, H., Harris, M., Spooner, C., Ross, H., . . . Karnon, J. (2015). Engaging practice nurses in obesity management – a clinical academic partnership to pilot the Counterweight Program [Presentation]. Poster session presented at the meeting of PHC Research Conference. Adelaide, Australia.
2015	Hajiali Afzali, H., Karnon, J., & Sculpher, M. (2015). Should the lambda remain silent?. Poster session presented at the meeting of 12th Annual Conference of Health Technology Assessment International (HTAi).. Oslo: Norway.
2015	Hajiali Afzali, H. (2015). Structural uncertainty in decision making. Poster session presented at the meeting of Centre for Health Economics. Monash University. Melbourne-Australia.
2014	Hajiali Afzali, H. (2014). Improving the quality of decisions around the public funding of new health technologies: The value of disease-specific (reference) models. Poster session presented at the meeting of 11th Annual Conference of Health Technology Assessment International (HTAi).. Washington DC: USA.
2013	• Haji Ali Afzali, H., Karnon, J., Merlin, T., & Hajiali Afzali, H. (2013). Improving the accuracy and comparability of model-based economic evaluations of health technologies for reimbursement decisions: a methodological framework for the development of reference models.. Poster session presented at the meeting of the 10th Annual Health Technology Assessment international (HTAi) Conference. Seoul, South Korea.
2011	Gray, J. P., Hajiali Afzali, H., & Karnon, J. (2011). A model based evaluation of primary care based initiatives in the management of patients with obesity in Australia [Plenary presentation]. Poster session presented at the meeting of Tri State PHCRED Annual Conference. Adelaide, Australia.

Research Support / Grants Held / Consultancy projects Role

Competitive Research Funding

National Competitive Schemes

Date	Project/No.	Investigators	Funding Body	Amount
2016 - 2019	Delivering effective dental healthcare in 2020-2030: A national longitudinal partnership study of burden of oral diseases in Australia	Hossein Haji Ali Afzali- Associate investigator	National Health and Medical Research Council (NHMRC) (Grant ID: 1115649)	$1,056,500
July 2015 - June 2016	Review of the Pharmaceutical Benefits Advisory Committee (PBAC) Guidelines	Hossein Hajiali Afzail - Chief investigator	Department of Health	$533,000
April 2015 - July 2015	A critical review of decision analytic models submitted to PBAC and NICE: Need for disease-specific (reference) models	Hossein Hajiali Afzail - Chief investigator	Centre for Health Economics, The University of York (UK) (International visiting research fellowship: The Alan Williams Fellowship)	$10,000
2015 - 2017	Estimation of the cost-effectiveness threshold for the Australian health system	Hossein Hajiali Afzail - Chief investigator	National Health and Medical Research Council (NHMRC) (Grant ID: 1084387)	$331,000
2014 - 2017	Can e-Health improve post-marketing surveillance of drugs and vaccines? The Stimulated Telephone Assisted Rapid Safety Surveillance (STARSS) randomised controlled trial	Hossein Hajiali Afzail - Chief investigator (leading the health economics component)	National Health and Medical Research Council (NHMRC) (Grant ID: 1067703)	$732,000
	The impact of death and disability from invasive meningococcal disease (IMD) in Australian children.	Hossein Hajiali Afzail - Chief investigator (leading the health economics component)	Pfizer	$835,072
2012 - 2015	Capacity Building Grant in Population Health and Health Services Research: Building capacity for integrated decision-making for improving health services	Hossein Hajiali Afzail - Team Investigator	National Health and Medical Research Council (NHMRC) (Grant ID: 56550)	$2,094,000
2009 - 2011	Primary Care Services Improvement Project (PCSIP)	Hossein Hajiali Afzail - Project Manager	Australian Research Council (ARC) (Grant ID: LP0883930)	$577,000
2006 - 2007	The University of Adelaide Efficiency measurement for hospitals owned by the Iranian Social Security Organisation	Hossein Hajiali Afzail - Chief investigator	Adelaide Graduate Centre Research Abroad Scholarship	$2,500
2005 - 2006	The University of Adelaide Postgraduate Travelling Fellowship Award	Hossein Hajiali Afzail - Chief investigator	Faculty of Health Sciences	$5,000

Teaching

2014- Ongoing Course coordinator: PUB HLTH 7082 Health Economics (face to face) (Core course: Master of Health Economics and Policy)

2015- Ongoing Course coordinator: PUB HLTH 7082OL Health Economics (fully online) (Core course: Master of Health Economics and Policy

2016-Ongoing Course coordinator: HLTH SC 2012 Hacking Health: Core course for BHlthMedSc (Advanced)

2016-Ongoing Module (economic evaluation) coordinator: PUB HLTH 7091 Knowing What Works - Evaluation for Public Health (Core course: Master of Public Health)

2014-Ongoing Course coordinator: Health economics (for third-year medical students) as part of Medical, Personal and Professional Development III (MPPD III)

2010- Ongoing Lecturer: PubHlth 7082 Health Economic Evaluation and Decision Making (Core course: Master of Health Economics and Policy)

2012- Ongoing Lecturer: PubHlth 7147 (Health Technology Assessment)

Past Higher Degree by Research Supervision (University of Adelaide)

Date	Role	Research Topic	Program	Degree Type	Student Load	Student Name
2014 - 2019	Co-Supervisor	Improving Adolescent Health Through Immunisation: A Case Study - Invasive Meningococcal Disease	Doctor of Philosophy	Doctorate	Full Time	Dr Bing Wang
2012 - 2014	Co-Supervisor	Clinical outcomes, costs, knowledge and awareness of invasive meningococcal disease (IMD) in South Australia	Master of Philosophy (Public Health)	Master	Full Time	Dr Bing Wang

Consulting/Advisories

Date	Institution	Department	Organisation Type	Country
2015 - ongoing	-	-	-	-
2012 - ongoing	Adelaide Health Technology Assessment (AHTA)	-	-	Australia
2012 - 2014	Australian Catholic University	-	-	Australia

Editorial Boards

Date Role Editorial Board Name Institution Country
2014 - ongoing Board Member Applied Health Economics and Health Policy - Australia

Date	Role	Editorial Board Name	Institution	Country
2014 - ongoing	Board Member	Applied Health Economics and Health Policy	-	Australia

Email: hossein.hajialiafzali@adelaide.edu.au