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 | Health/Medicine | Health Systems | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Government/Law | 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 | Health/Medicine | Health Systems | Policy/Regulation | Culture/Society | Economics/Finance | Government/Law | 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…
Priority Setting/Ethics | Health/Medicine | Health Systems | Preferences/Values | Cost-Effectiveness Analysis | Policy/Regulation | Global -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Priority Setting/Ethics | Energy/Engineering | Social Determinants | Cost-Effectiveness Analysis | Chronic Disease/Risk | Environmental Health | Policy/Regulation | Climate/Environment | Economics/Finance | Science/Technology | Asia & Pacific -
ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Priority Setting/Ethics | Health/Medicine | Health Systems | Mathematical Models | Cost-Effectiveness Analysis | Operations Research | Infectious Diseases | Economics/Finance | Sub-Saharan Africa -
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 | Health/Medicine | Health Systems | Decision Psychology | Mathematical Models | Infectious Diseases | Global Governance | Economics/Finance | Government/Law | Global -
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 | Health/Medicine | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Cost-Effectiveness Thresholds: Pros and Cons
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. …
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. Cost-effectiveness thresholds allow health decision makers to identify cost-effectiveness ratios that represent good or bad value for money. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, these thresholds have been used as decision rules. However, this approach lacks country specificity…
Priority Setting/Ethics | Health/Medicine | Health Systems | Cost-Effectiveness Analysis -
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.…
Priority Setting/Ethics | Health/Medicine | Health Systems | Costing Methods | Maternal/Reproductive Health | Child/Nutrition | Economics/Finance | Global