Resources Repository
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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 | Preferences/Values | Global | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | 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…
Evidence Synthesis | Priority Setting/Ethics | Global | Health Systems | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2018Cost-Effectiveness of Strategies to Prevent Road Traffic Injuries in Eastern Sub-Saharan Africa and Southeast Asia: New Results from WHO-CHOICE
The authors applied a generalized cost-effectiveness analysis (GCEA) approach, applying a null reference case, in …
The authors applied a generalized cost-effectiveness analysis (GCEA) approach, applying a null reference case, in which the effects of currently implemented interventions were subtracted from current rates of burden, in order to identify the most efficient package of interventions that could be applied to Road Traffic Injuries (RTIs). They used a population model to estimate costs and effectiveness of interventions over a 100 year time frame in eastern sub-Saharan Africa and Southeast Asia. All heath…
State-Transition | Sub-Saharan Africa | Policy/Regulation | Injuries/Accidents | Cost-Effectiveness Analysis | Culture/Society | Science/Technology | Asia & Pacific -
Working PaperPublication 2018Valuing Mortality Risk Reductions in Global Benefit-Cost Analysis
Increasing life expectancy is a major goal of many policies implemented around the world. As …
Increasing life expectancy is a major goal of many policies implemented around the world. As a result, the value of reducing mortality risk has been extensively studied and several organizations have developed recommendations for estimating these values in benefit-cost analysis. However, both the recommendations and the underlying research primarily address high-income settings, raising questions about the extent to which the results are applicable in low- and middle-income countries. The recommendations are also diverse, reflecting differing…
Priority Setting/Ethics | Preferences/Values | Global | Policy/Regulation | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine -
Working PaperPublication 2018Valuing Nonfatal Health Risk Reductions
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- …
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- and middle-income countries. The approach for valuation ideally would be based on estimates of individuals’ willingness to pay for changes in their own risks. However, high quality valuation research is not available for many nonfatal conditions even in high-income settings. Typically, two approaches are used either alone or in combination as rough proxies. The first involves applying an estimate of…
Priority Setting/Ethics | Preferences/Values | Global | Policy/Regulation | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Critical Thinking/Analysis -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Risk Analysis | Global | Policy/Regulation | Health Systems | Dynamic Transmission | Decision Analysis | Infectious Diseases | Government/Law | Health/Medicine | Science/Technology -
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 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 | Sub-Saharan Africa | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | 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 | Global | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe