Resources Repository
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ArticlePublication 2016Country-Level Cost-Effectiveness Thresholds
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income …
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four…
Priority Setting/Ethics | Asia & Pacific | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe -
ArticlePublication 2016Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and …
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, the authors reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Using a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement…
Evidence Synthesis | Asia & Pacific | Health Systems | Health Outcomes | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2016Essential Package of Cancer Control: Costs, Affordability, and Feasibility of an Essential Package of Cancer Control Interventions in LMIC Countries
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in …
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Disease Control Priorities, 3rd edition developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of…
Costing Methods | Global | Health Systems | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | Science/Technology -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Priority Setting/Ethics | Global | Health Systems | Cost-Effectiveness Analysis | Mental Health | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2016What Determines HIV Prevention Costs at Scale?
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, …
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs, and thus, policymakers have little guidance in how best to design programmes that are…
Costing Methods | Asia & Pacific | Health Systems | Cost-Effectiveness Analysis | Infectious Diseases | Global Governance | Economics/Finance | Government/Law | Health/Medicine -
ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Priority Setting/Ethics | Asia & Pacific | Health Systems | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Technology Assessment | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Costing Methods | Global | Health Systems | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine -
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 | Asia & Pacific | Health Systems | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean -
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 | Global | Health Systems | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe