Resources Repository
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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 | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Policy/Regulation | Education/Labor | Government/Law | Health/Medicine | 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 | Cost-Effectiveness Analysis | Science/Technology | Health Systems | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | 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 | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Benefit-Cost Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health/Medicine | Global -
ArticlePublication 2016An Economic Evaluation of the PEN Program in Indonesia
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) …
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) introduced the Package of Essential Noncommunicable disease (PEN) interventions. Several countries, including Indonesia, implemented the PEN program. To assess the value of the investment in the current program, an economic evaluation of the program was conducted with collaboration between the Ministry of Health in Indonesia, the WHO, and the International Decision Support Initiative (iDSI). This study evaluated the delivery of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Technology Assessment | Chronic Disease/Risk | Government/Law | Health/Medicine | Asia & Pacific -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening
General frameworks of the cancer screening process are available, but none directly compare the process …
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. This paper presents a conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based…
Preferences/Values | Cost-Effectiveness Analysis | Science/Technology | Health Systems | Health Outcomes | Evidence Synthesis | Test Performance | Microsimulation | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2015Publicly Financed HPV Vaccination in China: Extended Cost-Effectiveness Analysis
This extended cost-effectiveness analysis evaluates public financing of HPV vaccination in China to prevent cervical cancer. Authors …
This extended cost-effectiveness analysis evaluates public financing of HPV vaccination in China to prevent cervical cancer. Authors estimated the distribution of deaths averted by income quintile, compared vaccination paired with screening against current practice. They estimated reductions in cervical cancer incidence, net costs to the government, and patient cost savings, as well as the incremental government health care costs per death averted. When the cost per HPV vaccination is less than US$50 per vaccinated girl, vaccination was…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Microsimulation | Chronic Disease/Risk | Health/Medicine | Asia & Pacific -
ArticlePublication 2008Health and Economic Implications of HPV Vaccination in the U.S.
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical …
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls in the US (at 12 years of age), and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). The study also examined the health benefits of averting other HPV-16-related and HPV-18-related cancers, the prevention of HPV-6-related and HPV-11-related genital warts and…
Cost-Effectiveness Analysis | Economics/Finance | Science/Technology | Health Systems | Dynamic Transmission | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in the Asia Pacific Region
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, …
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for vaccination of young adolescent girls against human papillomavirus (HPV) types 16 and 18. The authors used population-based and epidemiologic data for 25 countries in Asia (22 GAVI-Alliance eligible countries, Thailand, China and Japan). They found that an absolute reduction in lifetime cancer risk varied across countries, depending on incidence,…
Cost-Effectiveness Analysis | Economics/Finance | Science/Technology | Health Systems | Mathematical Models | Microsimulation | Calibration/Validation | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Asia & Pacific