Resources Repository
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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 | Global | Policy/Regulation | Health Systems | Culture/Society | Economics/Finance | Government/Law | Health/Medicine -
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 | Global | Policy/Regulation | Health Systems | Preferences/Values | Cost-Effectiveness Analysis | Health/Medicine -
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 | Mental Health | Cost-Effectiveness Analysis | Social Determinants | Economics/Finance | Health/Medicine -
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 | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | 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 | Global | Health Systems | Mental Health | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine -
ArticlePublication 2022Conceptualizing Monetary Benchmarks for Health Investments toward Poverty Reduction
Public spending can improve population well-being, for example, by averting or reducing poverty. This article …
Public spending can improve population well-being, for example, by averting or reducing poverty. This article aims to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower-middle-income countries. Priority setting in low- and lower-middle-income countries could be informed by health-sector PRBs (poverty reduction benchmarks), in addition to burden of disease and cost-effectiveness considerations. The computed PRBs, expressed in dollars per poverty case averted, can possibly be viewed in a manner…
Priority Setting/Ethics | Global | Health Systems | Evidence Synthesis | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2021Toward Universal Health Coverage Post-COVID-19
During the COVID-19 pandemic and beyond, advancement toward universal health coverage will become more difficult …
During the COVID-19 pandemic and beyond, advancement toward universal health coverage will become more difficult for many countries, demonstrating that locally led priority setting is urgently needed to provide health services with appropriate financial protection to all. Resources are limited and no national constituency can provide an unlimited number of services to their whole population in a sustainable manner, so rationing and setting priorities for the selection of interventions to be included in a defined…
Priority Setting/Ethics | Global | Policy/Regulation -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Priority Setting/Ethics | Global | Policy/Regulation | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2020Impact of Treatment and Imaging Modalities on 5-Year Net Survival of 11 Cancers in 200 Countries
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 …
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 countries/territories for 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate). The paper estimated current 5-year net survival for diagnosed cancers in each country and potential survival gains from increasing the availability of individual treatment and imaging modalities, and more comprehensive packages of scale-up. Global 5-year net survival for all 11 cancers (combined) is…
Priority Setting/Ethics | Calibration/Validation | Global | Health Systems | Health Outcomes | Microsimulation | Chronic Disease/Risk