Resources Repository
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ArticlePublication 2016Estimation of the Cost-Effectiveness Threshold: Why, What, How?
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international …
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international settings. While many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions, the threshold value is often controversial and not publicly available. Even when available, it often lacks a theoretical or empirical basis. This article aims to identify and critically appraise the conceptual perspectives and methodologies used to date to estimate the cost-effectiveness threshold. The authors…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Culture/Society | Health/Medicine -
ArticlePublication 2016Essential Package of Cancer Control: Costs, Affordability, and Feasibility of an Essential Package of Cancer Control Interventions in LMIC Countries
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in …
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Disease Control Priorities, 3rd edition developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of…
Cost-Effectiveness Analysis | Health Systems | Costing Methods | Chronic Disease/Risk | Health/Medicine | Science/Technology | Global -
ArticlePublication 2016An Extended CEA of Schizophrenia Treatment in India under Universal Public Finance
This paper evaluates the potential health and financial risk protection effects of a policy of …
This paper evaluates the potential health and financial risk protection effects of a policy of universal public finance (UPF) to treating schizophrenia in India. The study uses the extended cost effectiveness analysis framework across income quintiles. The results show financial protection benefits concentrated in the richest income quintiles, while health gains were concentrated among the poorest. The value of insurance is highest for the poorest income and decreases as the household income increases. In settings…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Costing Methods | Mental Health | Clinical Care | Culture/Society | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2016What Determines HIV Prevention Costs at Scale?
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, …
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs, and thus, policymakers have little guidance in how best to design programmes that are…
Cost-Effectiveness Analysis | Health Systems | Costing Methods | Infectious Diseases | Global Governance | Economics/Finance | Government/Law | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Cost-Effectiveness Analysis | Health Systems | Costing Methods | Infectious Diseases | Economics/Finance | Health/Medicine | Global -
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 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 -
ReviewPublication 2016Review: CEA for Maternal, Newborn, Child Health
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions …
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions to improve reproductive, maternal, newborn, and child health. Interventions for newborn health, treatment of febrile illness, immunization against preventable diseases, and micronutrient interventions remain among the most cost-effective and affordable. Other studies explore how to provide existing interventions using new platforms to increase outreach or decrease cost per person covered, or both. Interventions provided in the community may achieve both purposes to…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Education/Labor | Health/Medicine | Global