Resources Repository
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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 | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Clinical Care | Costing Methods | Health Outcomes | Infectious Diseases | Social Determinants | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2021Health Opportunity Cost Threshold for CEA in the U.S.
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, …
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health Outcomes | Evidence Synthesis | Microsimulation | Health/Medicine | North America -
ArticlePublication 2018HTA and MCDA Solely or Combined? The Case of Priority-Setting in Colombia
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related …
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related to setting priorities. Two methods, Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as tools to assist in informed decision-making, but both have advantages and disadvantages. Colombia established a Health Technology Assessment Institute in 2012. The authors discuss challenges faced by the Colombian health system, characteristics of HTA in Colombia and the potential benefits and drawbacks of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health/Medicine | Latin America & Caribbean -
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 | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Preferences/Values | Health/Medicine | 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 | Cost-Effectiveness Analysis | Policy/Regulation | Environmental Health | Chronic Disease/Risk | Social Determinants | Climate/Environment | Economics/Finance | Energy/Engineering | Science/Technology | Asia & Pacific -
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 Systems | Clinical Care | Costing Methods | Mental Health | Culture/Society | Economics/Finance | Health/Medicine | 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 | Policy/Regulation | Health Systems | Economics/Finance | 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 | Policy/Regulation | Health Systems | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2015Health Gains & Financial Risk Protection by Public Financing in Ethiopia: An ECEA
This article, published in the Lancet Global Health, aims to evaluate the health and financial …
This article, published in the Lancet Global Health, aims to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. The authors used an extended cost-effectiveness analysis (ECEA) to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine interventions that the Government of Ethiopia aims to make universally available. This approach incorporates financial…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa