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…
Global | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine -
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…
Sub-Saharan Africa | Policy/Regulation | Health Systems | Cost-Effectiveness Analysis | Clinical Care | Health/Medicine -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Global | Policy/Regulation | Health Systems | Dynamic Transmission | Decision Analysis | Risk Analysis | Infectious Diseases | Government/Law | Health/Medicine | Science/Technology -
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…
Global | Policy/Regulation | Health Systems | Priority Setting/Ethics | Culture/Society | Economics/Finance | Government/Law | Health/Medicine -
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…
Global | Policy/Regulation | Health Systems | Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine -
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;…
Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | 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…
Global | Policy/Regulation | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe -
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…
Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | 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…
Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Food/Agriculture | Health/Medicine