Resources Repository
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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 Systems | Priority Setting/Ethics | Policy/Regulation | 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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Economics/Finance | Health/Medicine | Global -
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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Technology Assessment | Chronic Disease/Risk | Economics/Finance | Government/Law | 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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Culture/Society | Economics/Finance | Government/Law | Health/Medicine | Global -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Thirty Years of Vaccination in Vietnam: Impact and Cost-Effectiveness
Countries like Vietnam transitioning to middle-income status increasingly bear the cost of both existing and …
Countries like Vietnam transitioning to middle-income status increasingly bear the cost of both existing and new vaccines. However, the impact and cost-effectiveness of the Expanded Programme on Immunization (EPI) as a whole has never been assessed on a country level. Data on vaccine-preventable disease incidence and mortality from Vietnam's national surveillance was analyzed to estimate the likely impact that vaccination in 1980–2010 may have had. The same data were separately analyzed using the Lives Saved Tool…
Cost-Effectiveness Analysis | Health Systems | Infectious Diseases | Economics/Finance | Health/Medicine | Asia & Pacific -
ReviewWeb Portal 2015Science of Making Better Decisions About Health: CEA and BCA
This chapter reviews the main scientific methods for guiding the allocation of resources to health: cost-effectiveness …
This chapter reviews the main scientific methods for guiding the allocation of resources to health: cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA), sketches their methodological progress over the last several decades, and presents examples of how medical practice in other high-income countries, where people live longer, follows the priorities indicated by cost-effectiveness analysis.
Cost-Effectiveness Analysis | Health Systems | Benefit-Cost Analysis | Policy/Regulation | Health/Medicine | North America -
Working PaperPublication 2015Benefit-Cost Analysis and the Cities
This paper provides a short introduction to the use of benefit-cost analysis to assess interventions …
This paper provides a short introduction to the use of benefit-cost analysis to assess interventions undertaken at the city or municipal level. It introduces the concepts that underlie the conduct of benefit-cost analysis, describes the major analytic components, and discusses how to tailor the analysis to the characteristics of the policy and the resources available. It concludes with a list of references for those interested in learning more.
Decision Analysis | Social Determinants | Preferences/Values | Priority Setting/Ethics | Benefit-Cost Analysis | Environmental Health | Policy/Regulation | Climate/Environment | Culture/Society | Economics/Finance | Government/Law | North America | Critical Thinking/Analysis