Resources Repository
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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…
Europe | Sub-Saharan Africa | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | 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…
Europe | Global | Health Systems | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2014Cost-Effectiveness of Female HPV Vaccination in 179 Countries: A PRIME Modelling Study
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), …
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), used to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. The PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programs…
Sub-Saharan Africa | Global | Health Systems | Health Outcomes | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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…
Global | Health Systems | Health Outcomes | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | 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…
Global | Health Systems | Health Outcomes | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | Health/Medicine -
ArticlePublication 2023Estimated Travel Time & Staffing Constraints to Accessing the Ethiopian Healthcare System: Two-Step Floating Catchment Area Analysis
This study investigates disparities in health care access across different income levels and geographic locations …
This study investigates disparities in health care access across different income levels and geographic locations in Ethiopia. Employing a two-step floating catchment area method, the research estimates variations in spatial access to health care and staffing levels at facilities. Average travel time from population centers is calculated and adjusted with provider-to-population ratios. Spearman's rank tests are applied to test hypotheses about the roles of travel time versus staffing in access variations. Results reveal regional disparities,…
Sub-Saharan Africa | Health Systems | 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…
Global | Health Systems | Priority Setting/Ethics | Evidence Synthesis | Social Determinants | Economics/Finance | 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…
Global | Health Systems | Cost-Effectiveness Analysis | Policy/Regulation | 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…
Global | Health Systems | Costing Methods | Evidence Synthesis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine