Resources Repository
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ArticlePublication 2016Estimation of the Cost-Effectiveness Threshold: Why, What, How?
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international …
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international settings. While many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions, the threshold value is often controversial and not publicly available. Even when available, it often lacks a theoretical or empirical basis. This article aims to identify and critically appraise the conceptual perspectives and methodologies used to date to estimate the cost-effectiveness threshold. The authors…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Culture/Society -
ArticlePublication 2016Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to …
Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in…
Operations Research | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Health Outcomes | Chronic Disease/Risk | Clinical Care | Economics/Finance | Europe -
ArticlePublication 2016An Extended CEA of Schizophrenia Treatment in India under Universal Public Finance
This paper evaluates the potential health and financial risk protection effects of a policy of …
This paper evaluates the potential health and financial risk protection effects of a policy of universal public finance (UPF) to treating schizophrenia in India. The study uses the extended cost effectiveness analysis framework across income quintiles. The results show financial protection benefits concentrated in the richest income quintiles, while health gains were concentrated among the poorest. The value of insurance is highest for the poorest income and decreases as the household income increases. In settings…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Mental Health | Clinical Care | Culture/Society | Economics/Finance | Asia & Pacific -
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 | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Mental Health | Social Determinants | Economics/Finance | Global -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Economics/Finance | Education/Labor | Sub-Saharan Africa | 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;…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Policy/Regulation | 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 | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Culture/Society | Economics/Finance | Government/Law | Global -
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 | Health/Medicine | Health Systems | Economics/Finance | Sub-Saharan Africa