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 | Cost-Effectiveness Analysis | Economics/Finance | Policy/Regulation | Health Systems | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Cost-Effectiveness Analysis | Economics/Finance | Policy/Regulation | Health Systems | Costing Methods | Chronic Disease/Risk | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
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 | Cost-Effectiveness Analysis | Economics/Finance | Policy/Regulation | Health Systems | Costing Methods | Health Outcomes | Infectious Diseases | Social Determinants | Clinical Care | Health/Medicine | Asia & Pacific -
ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Priority Setting/Ethics | Operations Research | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Mathematical Models | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
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 | Economics/Finance | Policy/Regulation | Health Systems | Health/Medicine | Global -
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 | Cost-Effectiveness Analysis | Economics/Finance | Policy/Regulation | Benefit-Cost Analysis | Infectious Diseases | Health/Medicine | Global | North America -
ArticleWeb Portal 2017PLoS Collection: Prevention, Diagnosis and Treatment of Sexually Transmitted Infections
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted …
Globally, the World Health Organization (WHO) estimates that more than one million new sexually transmitted infections (STIs) occur each day, incurring a very substantial burden of morbidity, mortality and additional infections. The pathogens responsible include bacteria, parasites and viruses, and intensive research is needed to address the substantial barriers to diagnosis and treatment of STIs, and the behavioral challenges of prevention. This PLOS collection, published in collaboration with WHO, focuses on global policy and systems…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Costing Methods | Mathematical Models | Dynamic Transmission | Infectious Diseases | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Costing Methods | Mathematical Models | Infectious Diseases | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Health Systems | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Government/Law | Health/Medicine | Science/Technology | Global