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;…
Priority Setting/Ethics | Latin America & Caribbean | Sub-Saharan Africa | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Middle East & North Africa | Asia & Pacific -
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 | Latin America & Caribbean | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Health/Medicine -
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 | Latin America & Caribbean | Sub-Saharan Africa | Health Systems | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Middle East & North Africa | Asia & Pacific -
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 | Latin America & Caribbean | Sub-Saharan Africa | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Middle East & North Africa | Europe | Asia & Pacific -
ArticlePublication 2016Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and …
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, the authors reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Using a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement…
Evidence Synthesis | Latin America & Caribbean | Sub-Saharan Africa | Health Systems | Health Outcomes | Chronic Disease/Risk | Health/Medicine | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2015Health Gains & Financial Risk Protection by Public Financing in Ethiopia: An ECEA
This article, published in the Lancet Global Health, aims to evaluate the health and financial …
This article, published in the Lancet Global Health, aims to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. The authors used an extended cost-effectiveness analysis (ECEA) to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine interventions that the Government of Ethiopia aims to make universally available. This approach incorporates financial…
Priority Setting/Ethics | Sub-Saharan Africa | Policy/Regulation | Health Systems | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health/Medicine -
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 | Sub-Saharan Africa | Policy/Regulation | Health Systems | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Food/Agriculture | Health/Medicine -
ArticlePublication 2022Equity Impact of Minimum Unit Pricing of Alcohol
South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) …
South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa. Authors estimate MUP would reduce consumption more among the poorest than the richest drinkers. A MUP policy in South Africa has…
Priority Setting/Ethics | Sub-Saharan Africa | Policy/Regulation | Chronic Disease/Risk | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2020Health Gains & Financial Risk Protection Afforded by Public Financing of Selected Malaria Interventions in Ethiopia: An ECEA
This article, published in the Malaria Journal, aims to estimate the expected health and financial …
This article, published in the Malaria Journal, aims to estimate the expected health and financial risk protection (FRP) benefits of universal public financing of key malaria interventions in Ethiopia. An extended cost-effectiveness analysis (ECEA) is used to estimate the potential health and FRP benefits of publicly financing a 10% increase in artemisinin-based combination therapy (ACT), long-lasting insecticide-treated bed nets (LLIN), indoor residual spraying (IRS), and a hypothetical malaria vaccine. The results indicate that ACT, LLIN,…
Priority Setting/Ethics | Sub-Saharan Africa | Health Systems | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health/Medicine