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…
Preferences/Values | Cost-Effectiveness Analysis | Global | Policy/Regulation | Health Systems | Priority Setting/Ethics | Health/Medicine -
ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Evidence Synthesis | Microsimulation | Global | Health Systems | Health Outcomes | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | Health/Medicine -
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 | Global | Policy/Regulation | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Health Systems | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Policy/Regulation | Health/Medicine -
ArticlePublication 2017Cost-Effectiveness of Testing and Treatment for Latent TB
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve …
Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. This analysis estimated health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities (e.g., diabetes, HIV infection, and end-stage renal disease). A decision analytic tree and Markov cohort simulation model was used to compare the following strategies: no testing, tuberculin skin test (TST), interferon gamma release assay…
Microsimulation | Cost-Effectiveness Analysis | Global | Health Systems | Test Performance | State-Transition | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | North America -
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 | Global | Policy/Regulation | Health Systems | Priority Setting/Ethics | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Policy/Regulation | Priority Setting/Ethics | Health/Medicine -
ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Microsimulation | Global | Health Systems | Health Outcomes | Mathematical Models | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | Health/Medicine