Hossein Haji Ali Afzali

Prof Hossein Haji Ali Afzali

School of Public Health

College of Health

Available For Media Comment.

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.

Research Interests
  • Economic evaluation
  • Decision analytic modelling for health economic evaluation
  • Health technology assessment (HTA)
  • Hospital efficiency measurement

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

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)

Year Citation
2025 Ryder, C., Sharpe, P., Omodei-James, S., Sallows, G., Shannon, B., Möller, H., . . . Ivers, R. Q. (2025). “I didn't know nothing” - yarning up on access to compensation from road traffic injury with Aboriginal people. Journal of Transport and Health, 42, 9 pages.
DOI
2024 Toson, B., Edney, L. C., Haji Ali Afzali, H., Visvanathan, R., Khadka, J., & Karnon, J. (2024). Economic burden of frailty in older adults accessing community-based aged care services in Australia. Geriatrics and Gerontology International, 24(9), 939-947.
DOI Scopus5 WoS5 Europe PMC4
2024 Strube, T., Lambrakis, K., George, K., Lehman, S., Ali Afzali, H. H., & Chew, D. P. (2024). Could Computed Tomography Coronary Angiography Replace Invasive Coronary Angiography as a First-Line Diagnostic Investigation in Suspected Acute Coronary Syndromes? A Decision-Analytic Model. Heart Lung and Circulation, 33(3), 342-349.
DOI Scopus2 WoS3 Europe PMC3
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 Scopus3 WoS3 Europe PMC3
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 Scopus2 WoS1 Europe PMC1
2023 Merlin, T., Street, J., Carter, D., & Haji Ali Afzal, 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 Scopus4 WoS5 Europe PMC3
2023 Edney, L. C., Haji Ali Afzali, H., Visvanathan, R., Toson, B., & Karnon, J. (2023). An exploration of healthcare use in older people waiting for and receiving Australian community-based aged care services. Geriatrics and Gerontology International, 23(12), 899-905.
DOI Scopus3 WoS1 Europe PMC2
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 Scopus2 WoS2
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 Scopus1 WoS1
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 Scopus6 WoS6 Europe PMC5
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 Scopus29 WoS30 Europe PMC20
2021 Haji Ali Afzali, H., & Karnon, J. (2021). Expediting Patient Access to New Health Technologies: Role of Disease-Specific Reference Models. Value in Health, 24(6), 755-758.
DOI Scopus4 WoS4 Europe PMC4
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 Scopus10 WoS7 Europe PMC7
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 Scopus4 WoS5 Europe PMC3
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 Scopus3 WoS3 Europe PMC2
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 Scopus184 WoS165 Europe PMC142
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 Scopus5 WoS5 Europe PMC5
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 Scopus14 WoS14 Europe PMC12
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 Scopus8 WoS6 Europe PMC8
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 Scopus77
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 Scopus194 WoS178 Europe PMC149
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 Scopus6 WoS4 Europe PMC3
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 Scopus2 WoS2 Europe PMC1
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 Scopus20 WoS17 Europe PMC11
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 Scopus28 WoS24 Europe PMC23
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 Scopus17 WoS17 Europe PMC15
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 Scopus10 WoS9 Europe PMC6
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 WoS4 Europe PMC3
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 Scopus20 WoS19 Europe PMC20
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 Scopus2 WoS2 Europe PMC2
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 Scopus16 WoS16 Europe PMC12
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 Scopus16 WoS16 Europe PMC13
2016 Haji Ali Afzali, H., Karnon, J., & Sculpher, M. (2016). Should the Lambda (λ) Remain Silent?. Pharmacoeconomics, 34(4), 323-329.
DOI Scopus12 WoS11 Europe PMC7
2015 Haji Ali Afzali, H., & Karnon, J. (2015). Exploring structural uncertainty in model-based economic evaluations. PharmacoEconomics, 33(5), 435-443.
DOI Scopus28 WoS25 Europe PMC21
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 Scopus12 WoS10 Europe PMC8
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 Scopus66 WoS59 Europe PMC47
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 Scopus20 WoS19 Europe PMC15
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 Scopus23 WoS25 Europe PMC20
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 PMC2
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 Scopus33 WoS26 Europe PMC27
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 Scopus24 WoS22 Europe PMC21
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 PMC6
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 PMC8
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 Scopus18 WoS18 Europe PMC17
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 PMC11
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 Scopus30 WoS30 Europe PMC26
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 Scopus30 WoS26 Europe PMC21
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 PMC13
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 Scopus11 WoS10 Europe PMC12
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 Scopus17 WoS14 Europe PMC15
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 Scopus22 WoS17 Europe PMC16
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 Scopus42 WoS30 Europe PMC22
- Wang, B., Santoreneos, R., Giles, L., Afzali, H. H. A., & Marshall, H. (n.d.). Case Fatality Rates of Invasive Meningococcal Disease by Serogroup and Age: A Global Systematic Review and Meta-Analysis. SSRN Electronic Journal.
DOI

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 Scopus7

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

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.

Year Citation
2022 Karnon, J., Afzali, H., & Bonevski, B. (2022). Should rapid antigen tests be government funded in Australia? An economic evaluation.
DOI

Research Support / Grants Held / Consultancy projects Role

Research grants (Category 1) (Since 2020)

  • 2025-2030: (Chief Investigator): Enhanced Outcomes for young people with endometriosis through diagnostic delay reduction. NHMRC ($1,978,271)
  • 2025-2027: (Chief Investigator): Medication safety needs rounds: reducing medication-induced harm in aged care homes. MRFF ($999,847)
  • 2025-2030: (Chief Investigator): Establishing the Atrial Fibrillation Ablation National Cardiac Registry. MRFF ($6,999,912)
  • 2025-2027: (Chief Investigator): IMPACT - Indigenous measures for protecting and addressing critical trauma. MRFF ($999,181)  
  • 2024-2029: (Chief Investigator): SMART-PH- Digitising information for practice in public health. MRFF- National Critical Research Infrastructure ($2,999,842)
  • 2023-2027: (Chief Investigator): Giving Donor milk instead of formula in preterm infants: The GIFT Trial. NHMRC ($2,243,378)
  • 2023-2026: (Chief Investigator): Faecal Microbiota Transplantation to improve pain, symptom management and treatment efficacy in patients with pancreatic cancer. MRFF ($1,521,000)
  • 2023-2026: (Chief investigator): Implementation of an omega-3 precision nutrition strategy to prevent preterm birth. MRFF ($1,366,713).
  • 2021-2023: (Chief Investigator): 3D-Printed Facial Guards to reduce P2/N95 respirator leak and protect health care workers from COVID-19. MRFF ($973,119)
  • 2020-2025: (Chief Investigator): Iodine supplementation in pregnancy to improve early childhood neurodevelopment: how much is enough? MRFF ($3,235,000)
Teaching

Economic evaluation in health care: Over the past 15 years I have been coordinator for a number of undergraduate and postgraduate health economics courses at both Adelaide University and Flinders University including: ‘Health Economics’ (a core course for Master of Health Economics and Policy mainly focusing on economic evaluation of new pharmaceuticals), ‘Evaluation in Public Health’ (a core course for MPH), ‘Hacking Health’ (a core course for Advanced Bachelor of Health Sciences), and ‘MPPD3-Health Economics (a core course for 3rd year medical students). I was also coordinator of the following teaching programs at Flinders University (2019-2023)

  • Master of Public Health
  • Graduate Certificate in Public Health
  • Graduate Certificate in Health Promotion

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

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

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

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