Resources Repository
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ArticlePublication 2022Economic Evaluations of Health System Strengthening Activities
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations …
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations provide information on how these types of investment might best be balanced but can be challenging. This paper conducted a systematic review to evaluate how researchers address these economic evaluation challenges. The authors searches produced 1978 studies, out of which they included 36. Most studies used data from prospective trials and calculated cost-effectiveness directly from these trial inputs, rather than…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Economics/Finance | Health/Medicine | Global -
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…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Priority Setting/Ethics | Health Outcomes | Evidence Synthesis | Microsimulation | Health/Medicine | North America -
ArticlePublication 2020Impact of Cigarette Tax Increase in India
This article, published in Gates Open Research, examines the impact of a one-time large cigarette …
This article, published in Gates Open Research, examines the impact of a one-time large cigarette price increase, through an increase in excise tax, on health and financing outcomes in four Indian states. Extended cost-effectiveness analysis (ECEA) is used to estimate, across income quintiles, the life-years gained, treatment cost averted, number of men avoiding catastrophic health expenditures and extreme poverty, and additional tax revenue collected with a cigarette price increase to Indian Rupees (INR) 10 plus…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Chronic Disease/Risk | Health/Medicine | Asia & Pacific -
ArticlePublication 2019Country Contextualization of Cost-Effectiveness Studies
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods …
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods and models to a country level. Results from three contextualized cost-effectiveness analyses (CEAs) are presented, and the authors discuss how this evidence can inform priority setting in Ethiopia. This method of contextualized CEAs requires inclusion of national analysts and use of country-specific inputs for either costs, epidemiology, demography, baseline coverage or effects. Rank ordering of interventions by incremental cost-effectiveness ratios…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Clinical Care | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Priority Setting/Ethics | Health/Medicine | Latin America & Caribbean -
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…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Preferences/Values | Priority Setting/Ethics | Health/Medicine | Global -
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;…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Priority Setting/Ethics | 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 | Policy/Regulation | Health Systems | Costing Methods | Child/Nutrition | Clinical Care | Economics/Finance | Health/Medicine | North America