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 | Economics/Finance | Policy/Regulation | Cost-Effectiveness Analysis | Health Systems | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Economics/Finance | Mental Health | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Global -
ArticlePublication 2015Valuing Regulations Affecting Addictive or Habitual Goods
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies …
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies have suggested that such regulations have only small welfare benefits, as consumers value these goods despite health benefits from quitting, while other studies suggest that information or behavioral problems make existing consumption decisions a poor guide to welfare evaluation. This analysis examines potential utility offsets to health benefits of regulations affecting addictive or habitual goods theoretically and empirically. The paper…
Preferences/Values | Economics/Finance | Policy/Regulation | Benefit-Cost Analysis | Chronic Disease/Risk | Social Determinants | Culture/Society | Health/Medicine | North America -
ArticlePublication 2015Salt Reduction Policy in South Africa: Extended Cost-Effectiveness Analysis
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of …
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of a salt reduction policy in South Africa. The authors used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. They calculated the average out-of-pocket (OOP) cost of CVD care and estimated the reduction in OOP expenditures and government subsidies due to the policy. They also estimated the costs of policy implementation and financial risk protection (FRP) benefits. The…
Priority Setting/Ethics | Economics/Finance | Policy/Regulation | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Priority Setting/Ethics | Economics/Finance | Policy/Regulation | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health Systems | Clinical Care | Health/Medicine | Asia & Pacific -
ArticlePublication 2015Extended Cost-Effectiveness Analysis of Treatment and Prevention of Diarrhoea in Ethiopia
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits …
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits due to the treatment and prevention of diarrhoea (i.e., rotavirus vaccination) in Ethiopia. The authors use an economic model to examine the impacts of universal public finance (UPF) of diarrhoeal treatment alone, as opposed to diarrhoeal treatment along with rotavirus vaccination using extended cost-effectiveness analysis (ECEA). The study finds that diarrhoeal treatment paired with rotavirus vaccination is more cost effective…
Priority Setting/Ethics | Economics/Finance | Environmental Health | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Climate/Environment | Health/Medicine | Sub-Saharan Africa -
ReviewPublication 2015Medicare's Use of CEA for Prevention (But Not Treatment)
Medicare currently pays for 23 preventive services in its benefits package, the majority of which …
Medicare currently pays for 23 preventive services in its benefits package, the majority of which were added since 2005. In the past decade, the program has transformed from one essentially administering treatment claims, to one increasingly focused on health promotion and maintenance. What is largely unappreciated is the role cost-effectiveness analysis has played in the coverage of preventive services. This study reviews the role of cost-effectiveness analysis in Medicare coverage of preventive services and contrast it…
Priority Setting/Ethics | Economics/Finance | Policy/Regulation | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Health Systems | Government/Law | Health/Medicine | North America -
ReviewPublication 2013Valuing the Economic Benefits of Complex Interventions
This is a review of economic evaluations of complex health interventions. Complex interventions, involving interlinked …
This is a review of economic evaluations of complex health interventions. Complex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. The authors find that complex interventions may be problematic on two levels. First, the complexity means the intervention may not fit into one of the current appraisal systems, and/or second, maximizing health is not the only objective. This paper discusses the…
Preferences/Values | Economics/Finance | Policy/Regulation | Decision Analysis | Health Systems | Government/Law | Health/Medicine | Science/Technology | Europe -
ReviewPublication 2013Public Health Economics: Review of Guidance for Economic Evaluation
This is a systematic review of published guidance for the economic evaluation of public health …
This is a systematic review of published guidance for the economic evaluation of public health interventions. Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to advance health, and minimize opportunity cost. In this review, the authors identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts…
Priority Setting/Ethics | Economics/Finance | Policy/Regulation | Costing Methods | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Science/Technology | Europe