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…
Government/Law | Health/Medicine | Health Systems | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | 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…
Government/Law | Health/Medicine | Health Systems | Priority Setting/Ethics | Policy/Regulation | Culture/Society | Economics/Finance | Global -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Health/Medicine | Health Systems | Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Global -
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.…
Health/Medicine | Health Systems | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Maternal/Reproductive Health | Economics/Finance | Global -
ArticlePublication 2016Rotavirus Vaccines Contribute Towards UHC in A Mixed Public–Private Healthcare System
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from …
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from the household’s perspective. The authors found that rotavirus vaccination reduces rotavirus episodes and expenditure substantially and provides financial risk protection to all income groups. Although the rich are paying more out of pocket than the poor by utilizing more expensive healthcare, the poor are paying more in proportion to household income. Poverty reduction benefits are concentrated amongst the poorest two…
Health/Medicine | Health Systems | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Economics/Finance | Science/Technology | Asia & Pacific -
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;…
Government/Law | Health/Medicine | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Education/Labor | 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…
Government/Law | Health/Medicine | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Science/Technology | Global | Europe -
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…
Government/Law | Health/Medicine | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Culture/Society | Economics/Finance | Global -
ArticlePublication 2016Extended CEA: Diarrhea and Pneumonia in Ethiopia
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea …
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea in Ethiopia, with a focus on children under age five years. This extended cost-effectiveness analysis examines benefits by income quintile so that policy makers can better understand how each package affects different segments of the population and permits the incorporation of financial risk protection in the economic evaluation of health policies - both critical elements of universal health coverage.
Health/Medicine | Health Systems | Child/Nutrition | Priority Setting/Ethics | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Economics/Finance | Sub-Saharan Africa