Resources Repository
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ArticlePublication 2016Cost-Effectiveness Thresholds: Pros and Cons
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. …
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. Cost-effectiveness thresholds allow health decision makers to identify cost-effectiveness ratios that represent good or bad value for money. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, these thresholds have been used as decision rules. However, this approach lacks country specificity…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Culture/Society -
ReviewWeb Portal 2016Use of Economics in Informing U.S. Public Health Policy
The goal of this American Journal of Preventive Medicine supplement on “The Use of Economics …
The goal of this American Journal of Preventive Medicine supplement on “The Use of Economics in Informing U.S. Public Health Policy” is to influence policy researchers to identify and undertake economic research that generates the key evidence needed to inform policy. In public health, economic evaluation, primarily cost and cost-effectiveness analysis, has been widely used to demonstrate the economic burden of health-related conditions and the value of proposed programs and policies. However, despite the wealth…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Health Outcomes | Policy/Regulation | Economics/Finance | Government/Law | North America -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Mental Health | Clinical Care | Culture/Society | Economics/Finance | Asia & Pacific -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Mental Health | Social Determinants | Economics/Finance | Global -
ArticlePublication 2016Rotavirus Vaccines Contribute Towards UHC in A Mixed Public–Private Healthcare System
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from …
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from the household’s perspective. The authors found that rotavirus vaccination reduces rotavirus episodes and expenditure substantially and provides financial risk protection to all income groups. Although the rich are paying more out of pocket than the poor by utilizing more expensive healthcare, the poor are paying more in proportion to household income. Poverty reduction benefits are concentrated amongst the poorest two…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Infectious Diseases | Child/Nutrition | Social Determinants | Economics/Finance | Science/Technology | Asia & Pacific -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Economics/Finance | Education/Labor | Sub-Saharan Africa | Asia & Pacific -
ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Benefit-Cost Analysis | Technology Assessment | Policy/Regulation | Economics/Finance | Government/Law | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Cost-Effectiveness Analysis | Health/Medicine | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific