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 | Economics/Finance | Asia & Pacific | Middle East & North Africa | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Priority Setting/Ethics | Economics/Finance | North America | Global | Policy/Regulation | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | 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 | Economics/Finance | Asia & Pacific | Middle East & North Africa | Health Systems | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean -
ArticlePublication 2017Making Fair Choices on the Path to UHC: Applying Principles to Difficult Cases
Progress toward universal health coverage (UHC) requires making difficult trade-offs. The World Health Organization (WHO) …
Progress toward universal health coverage (UHC) requires making difficult trade-offs. The World Health Organization (WHO) Consultative Group on Equity and UHC has endorsed the principles for making such decisions. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases, and how should one adjudicate between them when their demands conflict? This article by some members of the…
Priority Setting/Ethics | Economics/Finance | Global | Policy/Regulation | Health Systems | Culture/Society | Government/Law | Health/Medicine -
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 | Economics/Finance | Asia & Pacific | Middle East & North Africa | Health Systems | Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Europe -
ArticlePublication 2015Population Health Model (POHEM): An Overview
This paper provides an overview of the rationale, methodology and applications of the Population Health …
This paper provides an overview of the rationale, methodology and applications of the Population Health Model (POHEM). POHEM is a health microsimulation model, developed at Statistics Canada in the early 1990s. The authors describe that POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals’ disease states, risk factors, and health determinants, in order…
Calibration/Validation | Economics/Finance | North America | Policy/Regulation | Health Systems | Costing Methods | Evidence Synthesis | Mathematical Models | Microsimulation | Chronic Disease/Risk | Clinical Care | Health/Medicine -
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 | Economics/Finance | Asia & Pacific | Policy/Regulation | Health Systems | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Clinical Care | Health/Medicine -
ArticlePublication 2022Conceptualizing Monetary Benchmarks for Health Investments toward Poverty Reduction
Public spending can improve population well-being, for example, by averting or reducing poverty. This article …
Public spending can improve population well-being, for example, by averting or reducing poverty. This article aims to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower-middle-income countries. Priority setting in low- and lower-middle-income countries could be informed by health-sector PRBs (poverty reduction benchmarks), in addition to burden of disease and cost-effectiveness considerations. The computed PRBs, expressed in dollars per poverty case averted, can possibly be viewed in a manner…
Priority Setting/Ethics | Economics/Finance | Global | Health Systems | Evidence Synthesis | Social Determinants | Health/Medicine -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
Value of Information | Economics/Finance | North America | Policy/Regulation | State-Transition | Benefit-Cost Analysis | Infectious Diseases | Europe