Resources Repository
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ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Priority Setting/Ethics | Government/Law | Health Systems | Infectious Diseases | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Making Fair Choices on the Path to UHC: Applying Principles to Difficult Cases
Progress toward universal health coverage (UHC) requires making difficult trade-offs. The World Health Organization (WHO) …
Progress toward universal health coverage (UHC) requires making difficult trade-offs. The World Health Organization (WHO) Consultative Group on Equity and UHC has endorsed the principles for making such decisions. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases, and how should one adjudicate between them when their demands conflict? This article by some members of the…
Priority Setting/Ethics | Government/Law | Culture/Society | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2017Policy Makers, the International Community and the Population: Case Study on HIV/AIDS
A four-period game is developed between a policy maker, the international community, and the population. …
A four-period game is developed between a policy maker, the international community, and the population. This research supplements, through implementing strategic interaction, earlier research analyzing "one player at a time." The first two players distribute funds between preventing and treating diseases. The population reacts by degree of risky behavior which may cause no disease, disease contraction, recovery, sickness/death. More funds to prevention implies less disease contraction but higher death rate given disease contraction. The cost…
Priority Setting/Ethics | Government/Law | Health Systems | Infectious Diseases | Decision Psychology | Mathematical Models | Global Governance | Economics/Finance | Health/Medicine | 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 | Government/Law | Education/Labor | Health Systems | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2016Defining a Health Benefits Package: What Are the Necessary Processes?
There is immense interest worldwide in the notion of universal health coverage. A major policy …
There is immense interest worldwide in the notion of universal health coverage. A major policy focus in moving toward universal health coverage has been on the key policy question: what services should be made available and under what conditions? This article focuses on how a feasible set of universal health coverage services can be explicitly defined to create what is commonly known as a “health benefits package”, a set of services that can be feasibly financed…
Priority Setting/Ethics | Government/Law | Culture/Society | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global -
ReviewPublication 2016Review: CEA for Maternal, Newborn, Child Health
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions …
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions to improve reproductive, maternal, newborn, and child health. Interventions for newborn health, treatment of febrile illness, immunization against preventable diseases, and micronutrient interventions remain among the most cost-effective and affordable. Other studies explore how to provide existing interventions using new platforms to increase outreach or decrease cost per person covered, or both. Interventions provided in the community may achieve both purposes to…
Priority Setting/Ethics | Education/Labor | Health Systems | Infectious Diseases | Costing Methods | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health/Medicine | Global -
ReviewPublication 2015Medicare's Use of CEA for Prevention (But Not Treatment)
Medicare currently pays for 23 preventive services in its benefits package, the majority of which …
Medicare currently pays for 23 preventive services in its benefits package, the majority of which were added since 2005. In the past decade, the program has transformed from one essentially administering treatment claims, to one increasingly focused on health promotion and maintenance. What is largely unappreciated is the role cost-effectiveness analysis has played in the coverage of preventive services. This study reviews the role of cost-effectiveness analysis in Medicare coverage of preventive services and contrast it…
Priority Setting/Ethics | Government/Law | Health Systems | Infectious Diseases | Cost-Effectiveness Analysis | Technology Assessment | Child/Nutrition | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2021Rational Policymaking during a Pandemic
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and …
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and its global impacts are unprecedented, decisions are taken in a highly uncertain, complex, and rapidly changing environment. In such a context, in which human lives and the economy are at stake, the authors argue that using ideas and constructs from modern decision theory, even informally, will make policymaking a more responsible and transparent process.
Priority Setting/Ethics | Government/Law | Infectious Diseases | Decision Theory | Policy/Regulation | Health/Medicine | Science/Technology | Global -
ArticlePublication 2018Trading Bankruptcy for Health: A Discrete-Choice Experiment
This article in Value in Health evaluates the importance of improved health as compared to …
This article in Value in Health evaluates the importance of improved health as compared to improved financial risk protection in the general United States population. Using a discrete-choice experiment, it finds that 31.3% of the population values cure at all costs, and 8.5% of the population use financial solvency to dominate medical decision making. This study shares insight to the US population values and trade-offs between health outcomes and financial health, and highlights the difficult…
Priority Setting/Ethics | Culture/Society | Health Systems | Preferences/Values | Health Outcomes | Economics/Finance | Health/Medicine | North America