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 | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health/Medicine | Global -
ArticlePublication 2015Salt Reduction Policy in South Africa: Extended Cost-Effectiveness Analysis
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of …
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of a salt reduction policy in South Africa. The authors used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. They calculated the average out-of-pocket (OOP) cost of CVD care and estimated the reduction in OOP expenditures and government subsidies due to the policy. They also estimated the costs of policy implementation and financial risk protection (FRP) benefits. The…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Costing Methods | Policy/Regulation | Health Systems | Chronic Disease/Risk | Economics/Finance | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Costing Methods | Policy/Regulation | Health Systems | Health Outcomes | Infectious Diseases | Social Determinants | Clinical Care | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2020Online Competition between Pro- and Anti-Vaccination Views
Distrust in scientific expertise is dangerous. Opposition to vaccination with a future vaccine against SARS-CoV-2, …
Distrust in scientific expertise is dangerous. Opposition to vaccination with a future vaccine against SARS-CoV-2, the causal agent of COVID-19, for example, could amplify outbreaks as happened for measles in 2019. Homemade remedies and falsehoods are being shared widely on the Internet, as well as dismissals of expert advice. There is a lack of understanding about how this distrust evolves at the system level. Authors provide a map of the contention surrounding vaccines that has…
Preferences/Values | Decision Psychology | Policy/Regulation | Health Systems | Infectious Diseases | Social Determinants | Culture/Society | Government/Law | Health/Medicine | Science/Technology | North America -
ArticlePublication 2021Health Opportunity Cost Threshold for CEA in the U.S.
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, …
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health Outcomes | Evidence Synthesis | Microsimulation | Health/Medicine | North America -
ArticlePublication 2018HTA and MCDA Solely or Combined? The Case of Priority-Setting in Colombia
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related …
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related to setting priorities. Two methods, Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as tools to assist in informed decision-making, but both have advantages and disadvantages. Colombia established a Health Technology Assessment Institute in 2012. The authors discuss challenges faced by the Colombian health system, characteristics of HTA in Colombia and the potential benefits and drawbacks of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health/Medicine | Latin America & Caribbean -
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 | Policy/Regulation | Health Systems | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2015Three Interventions That Reduce Childhood Obesity
Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. …
Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. The authors estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: (1) a sugar-sweetened beverage excise tax, (2) elimination of the tax subsidy for advertising unhealthy food to children, (3) restaurant menu calorie labeling, (4) nutrition standards for school meals, (5) nutrition standards for all other food and beverages sold in schools, (6) improved early care and…
Cost-Effectiveness Analysis | Costing Methods | Policy/Regulation | Health Systems | Child/Nutrition | Clinical Care | Economics/Finance | Health/Medicine | North America