This reports on the work undertaken by iDSI on each of the five objectives under the iDSI Reference Case (RC) work stream and on its future use by the Bill and Melinda Gates Foundation. The brief pilot studies’ report gives an overview of each of the pilots and extracts key issues for further RC development under iDSI going forward. The process of piloting the RC revealed that researchers found the RC challenging to fulfil every methodological and reporting standard, even those with substantial experience in economic evaluation in a low and middle income country (LMIC) context. Establishing a requirement that BMGF funded economic evaluation use of the RC ought to be accompanied by extensive efforts to build research capacity in modelling (mathematical, decision analytic) and cost-effectiveness analysis in LMICs
