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Resources Repository
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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 | Economics/Finance | Europe | Health Systems | Clinical Care | Health Outcomes | Chronic Disease/Risk -
ArticlePublication 2011Health and Economic Impact of HPV 16/18 Vaccination and Cervical Cancer Screening in Eastern Africa
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe …
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, they assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30, they assessed only screening (with HPV DNA testing up to three times per lifetime or VIA…
Cost-Effectiveness Analysis | Calibration/Validation | Health/Medicine | Economics/Finance | Science/Technology | Sub-Saharan Africa | Clinical Care | Microsimulation | Infectious Diseases | Chronic Disease/Risk -
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…
Operations Research | Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Health Systems | Priority Setting/Ethics | Mathematical Models | Infectious Diseases -
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…
Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Europe | Sub-Saharan Africa | Health Systems | Priority Setting/Ethics | Middle East & North Africa | Latin America & Caribbean | 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;…
Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Education/Labor | Government/Law | 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…
Cost-Effectiveness Analysis | Health/Medicine | Science/Technology | Europe | Policy/Regulation | Health Systems | Priority Setting/Ethics | Chronic Disease/Risk | Climate/Environment | Government/Law | Global -
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…
Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Costing Methods | Chronic Disease/Risk | Food/Agriculture -
ArticlePublication 2012Health and Economic Outcomes of Interventions to Reduce Pregnancy-Related Mortality in Nigeria
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed …
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed to reduce maternal mortality in Nigeria, a country with extremely high maternal mortality rates. Using a previously validated model adapted to the Nigerian context, the study finds that an increase of access to family planning is the most effective individual strategy, which not only reduces pregnancy-related mortality but also proves to be economically efficient. However, relying solely on family planning…
Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Policy/Regulation | Health Systems | Health Outcomes | State-Transition | Maternal/Reproductive Health -
ArticlePublication 2019Country Contextualization of Cost-Effectiveness Studies
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods …
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods and models to a country level. Results from three contextualized cost-effectiveness analyses (CEAs) are presented, and the authors discuss how this evidence can inform priority setting in Ethiopia. This method of contextualized CEAs requires inclusion of national analysts and use of country-specific inputs for either costs, epidemiology, demography, baseline coverage or effects. Rank ordering of interventions by incremental cost-effectiveness ratios…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Clinical Care