- theory and concepts
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Resources Repository
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ArticlePublication 2018Applications of ECEA Methodology in DCP3
Extended cost-effectiveness analyses (ECEAs) build on cost-effectiveness analyses (CEAs) by assessing consequences in both the …
Extended cost-effectiveness analyses (ECEAs) build on cost-effectiveness analyses (CEAs) by assessing consequences in both the health and non-health domains. The ECEA approach proves novel in that it includes equity and non-health benefits (FRP) in the economic evaluation of health policies, which enables multiple criteria to factor in the decision-making process. More important, the ECEA approach enables the design of benefits packages, such as essential universal health care and the highest-priority package, based on the quantitative…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Social Determinants | Global Governance | Health/Medicine | Global -
ArticlePublication 2019Health and Financial Benefits of Averting Malaria in Zambia: An ECEA
This study used the extended cost-effectiveness analysis (ECEA) to examine impact of the hypothetical rollout …
This study used the extended cost-effectiveness analysis (ECEA) to examine impact of the hypothetical rollout of the malaria vaccine RTS,S/AS01 in Zambia on the health benefits of children under five, and financial benefits on their households. The authors assumed a three-dose vaccination schedule (over 6-9 months), and vaccine cost of US$5 per dose. To assess vaccine impact, for each income quintile, they computed the number of under-five malaria deaths prevented, the household out-of-pocket (OOP) malaria-related…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Mathematical Models | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
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 | Health Systems | Policy/Regulation | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2017Getting it Right When Budgets are Tight: Prioritizing Responses to HIV Epidemics
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and …
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain.The authors examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Costing Methods | Mathematical Models | Infectious Diseases | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Policy Makers, the International Community and the Population: Case Study on HIV/AIDS
A four-period game is developed between a policy maker, the international community, and the population. …
A four-period game is developed between a policy maker, the international community, and the population. This research supplements, through implementing strategic interaction, earlier research analyzing "one player at a time." The first two players distribute funds between preventing and treating diseases. The population reacts by degree of risky behavior which may cause no disease, disease contraction, recovery, sickness/death. More funds to prevention implies less disease contraction but higher death rate given disease contraction. The cost…
Priority Setting/Ethics | Decision Psychology | Health Systems | Mathematical Models | Infectious Diseases | Global Governance | Economics/Finance | Government/Law | Health/Medicine | Global -
ArticlePublication 2016Country-Level Cost-Effectiveness Thresholds
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income …
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Cost-Effectiveness of Routine Vaccination With a Live-Attenuated Dengue Vaccine: Model Comparison
Large Phase III trials across Asia and Latin America have demonstrated the efficacy of a recombinant, …
Large Phase III trials across Asia and Latin America have demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 months following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. This paper reports predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine…
Cost-Effectiveness Analysis | Dynamic Transmission | Health Systems | Mathematical Models | Infectious Diseases | Child/Nutrition | Global Governance | Climate/Environment | Economics/Finance | Health/Medicine | Latin America & Caribbean | Asia & Pacific -
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 Systems | Health/Medicine