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 | Government/Law | Health Systems | Chronic Disease/Risk | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | 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 | Government/Law | Culture/Society | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Global -
ReportPublication 2018Estimating the Distributional Impact of Increasing Taxes on Tobacco Products in Armenia
Smoking is considered the leading risk factor for mortality among the Armenian population. The authors …
Smoking is considered the leading risk factor for mortality among the Armenian population. The authors conducted an extended cost-effectiveness analysis (ECEA) on increases in the excise tax on cigarettes in Armenia. Based on the World Health Organization recommendations, they analyzed the impact of a 75% increase of excise tax on the retail price of cigarettes. The ECEA found large health and financial benefits to the excise tax. It averted about 88,000 premature deaths, US$63 million of OOP…
Priority Setting/Ethics | Government/Law | Health Systems | Chronic Disease/Risk | Cost-Effectiveness Analysis | Policy/Regulation | Business/Industry | Economics/Finance | Health/Medicine | Europe -
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 | Government/Law | Education/Labor | Health Systems | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | 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 | Government/Law | Health Systems | Chronic Disease/Risk | Cost-Effectiveness Analysis | Policy/Regulation | Climate/Environment | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2016An Economic Evaluation of the PEN Program in Indonesia
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) …
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) introduced the Package of Essential Noncommunicable disease (PEN) interventions. Several countries, including Indonesia, implemented the PEN program. To assess the value of the investment in the current program, an economic evaluation of the program was conducted with collaboration between the Ministry of Health in Indonesia, the WHO, and the International Decision Support Initiative (iDSI). This study evaluated the delivery of…
Priority Setting/Ethics | Government/Law | Health Systems | Chronic Disease/Risk | Cost-Effectiveness Analysis | Technology Assessment | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Defining a Health Benefits Package: What Are the Necessary Processes?
There is immense interest worldwide in the notion of universal health coverage. A major policy …
There is immense interest worldwide in the notion of universal health coverage. A major policy focus in moving toward universal health coverage has been on the key policy question: what services should be made available and under what conditions? This article focuses on how a feasible set of universal health coverage services can be explicitly defined to create what is commonly known as a “health benefits package”, a set of services that can be feasibly financed…
Priority Setting/Ethics | Government/Law | Culture/Society | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global -
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 | Government/Law | Health Systems | Chronic Disease/Risk | Cost-Effectiveness Analysis | Technology Assessment | Infectious Diseases | Child/Nutrition | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2011Model-Based Analyses to Compare Health and Economic Outcomes of Cancer Control: Inclusion of Disparities
In order to identify strategies that improve both population health and ensure its equitable distribution, …
In order to identify strategies that improve both population health and ensure its equitable distribution, the authors developed a typology of cancer disparities that considers types of inequalities among black, white, and Hispanic populations across different cancers. This paper reports on the typology using an existing disease simulation model of cervical cancer that was calibrated to clinical, epidemiological, and cost data in the United States and presents characteristics important for policy discussions. The typology proposed…
Priority Setting/Ethics | Culture/Society | Health Systems | Chronic Disease/Risk | State-Transition | Cost-Effectiveness Analysis | Social Determinants | Clinical Care | Health/Medicine | Science/Technology | North America