Resources Repository
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Working PaperPublication 2024Economic Evaluation Primer
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence …
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence needed to support sound policy decisions. In low- and middle-income countries, where resources are especially scarce and needs are very great, such decisions are exceptionally difficult. In these settings, economic evaluation can be particularly useful in determining how to best improve health and welfare. Typically, cost-effectiveness analysis (CEA) is used to prioritize interventions within the health care sector. This approach…
Cost-Effectiveness Analysis | Costing Methods | Global | Policy/Regulation | Priority Setting/Ethics | Health Outcomes | Benefit-Cost 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…
Decision Analysis | Dynamic Transmission | Global | Policy/Regulation | Risk Analysis | Infectious Diseases | Health Systems | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2022Economic Evaluations of Health System Strengthening Activities
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations …
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations provide information on how these types of investment might best be balanced but can be challenging. This paper conducted a systematic review to evaluate how researchers address these economic evaluation challenges. The authors searches produced 1978 studies, out of which they included 36. Most studies used data from prospective trials and calculated cost-effectiveness directly from these trial inputs, rather than…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2018Consequences of a Cigarette Price Increase in 13 Middle Income Countries
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in …
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in market prices of cigarettes on health, poverty, and financial protection for men in 13 middle income countries. A 50% increase in cigarette prices would lead to about 450 million years of life gained across the 13 countries from smoking cessation, with half of these in China. Across all countries, men in the bottom income group would gain 6.7 times more…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Social Determinants | Health/Medicine -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Evidence Synthesis | 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…
Decision Analysis | Global | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Health Outcomes | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Critical Thinking/Analysis -
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…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Health Systems | Health/Medicine -
ArticlePublication 2017Cost-Effectiveness of a Policy Strategy to Decrease Sodium Intake: Global Analysis
The objective of this study was to assess the cost effectiveness of a government policy combining …
The objective of this study was to assess the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. To account for heterogeneity in efficacy across countries, a range of scenarios were evaluated, including 10%, 30%, 0.5 g/day, and 1.5 g/day sodium reductions achieved over 10 years. Country specific costs of a sodium reduction policy were estimated using the WHO Noncommunicable Disease Costing Tool. Country…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Child/Nutrition | Chronic Disease/Risk | Social Determinants | Food/Agriculture | Government/Law | Health/Medicine