Resources Repository
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ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Priority Setting/Ethics | Health/Medicine | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Operations Research | Health Systems | Economics/Finance | Sub-Saharan Africa -
ArticlePublication 2016Costs and Benefits of Integrated RMNCH
This chapter assesses the costs and benefits of delivering a set of integrated reproductive, maternal, …
This chapter assesses the costs and benefits of delivering a set of integrated reproductive, maternal, newborn and child health interventions in countries with high child and maternal mortality to demonstrate that very high returns can be achieved through this investment and to underscore the importance of an accurate assessment of those returns. This includes the full range of costs involved in delivering integrated care and the full range of benefits that flow from the interventions.…
Priority Setting/Ethics | Health/Medicine | Child/Nutrition | Costing Methods | Maternal/Reproductive Health | Health Systems | Economics/Finance | Global -
ArticlePublication 2016Departures from Cost-Effectiveness Recommendations: Health System Constraints
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality …
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality decision makers may be faced with numerous other constraints. The objective of this article is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance;…
Priority Setting/Ethics | Health/Medicine | Policy/Regulation | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Education/Labor | Government/Law | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2016Accounting for Technical, Ethical, and Political Factors in Priority Setting
This article investigates two cases of priority setting to explore how, in addition to technical …
This article investigates two cases of priority setting to explore how, in addition to technical considerations, ethical and political factors shape the allocation of health resources. First, they discuss how Thai authorities adjudicated a coverage decision for HLA-B*1502 screening, which meets the national cost-effectiveness threshold for only some of the conditions it can detect. Second, they consider England’s Cancer Drugs Fund to investigate the interplay of technical decision making and political reality. The findings suggest four concluding…
Priority Setting/Ethics | Health/Medicine | Policy/Regulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Climate/Environment | Government/Law | Science/Technology | Global | Europe -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Priority Setting/Ethics | Health/Medicine | Infectious Diseases | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Mental Health | Health Systems | Economics/Finance | Global -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Priority Setting/Ethics | Health/Medicine | Policy/Regulation | Evidence Synthesis | Cost-Effectiveness Analysis | Global -
ArticlePublication 2016Extended CEA: Home-Based Neonatal Care in Rural India
This chapter examines the health, economic benefits, and government costs associated with scaling up a …
This chapter examines the health, economic benefits, and government costs associated with scaling up a publicly financed home-based neonatal care package in rural India. This extended cost-effectiveness analysis considers two intervention scenarios against a baseline of no home-based neonatal care, both of which would utilize community health workers - one would provide coverage to approximately 7 out of 10 rural newborns, and the other would provide coverage to 9 out of 10 rural newborns.
Priority Setting/Ethics | Health/Medicine | Child/Nutrition | Cost-Effectiveness Analysis | Social Determinants | Health Systems | Economics/Finance | Asia & Pacific -
ArticlePublication 2015Broader Economic Impact of Vaccination: Reviewing and Appraising the Strength of Evidence
Economic evaluations of public health programs such as immunization often consider only direct health benefits and …
Economic evaluations of public health programs such as immunization often consider only direct health benefits and medical cost savings. Evidence linking immunization to important benefits in indicators such as childhood development, household behavior, and other macro-economic data are unclear. A conceptual framework of the pathways between immunization and these broader economic benefits was developed through expert consultation. The authors obtained articles from previous reviews, snowballing, and expert consultation, and associated them with one of the pathways and assessed them using modified Grading…
Priority Setting/Ethics | Health/Medicine | Infectious Diseases | Preferences/Values | Costing Methods | Evidence Synthesis | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Social Determinants | Economics/Finance | Education/Labor -
ArticlePublication 2015Salt Reduction Policy in South Africa: Extended Cost-Effectiveness Analysis
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of …
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of a salt reduction policy in South Africa. The authors used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. They calculated the average out-of-pocket (OOP) cost of CVD care and estimated the reduction in OOP expenditures and government subsidies due to the policy. They also estimated the costs of policy implementation and financial risk protection (FRP) benefits. The…
Priority Setting/Ethics | Health/Medicine | Policy/Regulation | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Food/Agriculture | Sub-Saharan Africa