Resources Repository
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ArticlePublication 2016Estimation of the Cost-Effectiveness Threshold: Why, What, How?
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international …
This is a systematic review of the thresholds used in cost-effectiveness analyses in several international settings. While many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions, the threshold value is often controversial and not publicly available. Even when available, it often lacks a theoretical or empirical basis. This article aims to identify and critically appraise the conceptual perspectives and methodologies used to date to estimate the cost-effectiveness threshold. The authors…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Culture/Society | Health/Medicine -
ArticlePublication 2016Essential Package of Cancer Control: Costs, Affordability, and Feasibility of an Essential Package of Cancer Control Interventions in LMIC Countries
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in …
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Disease Control Priorities, 3rd edition developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of…
Cost-Effectiveness Analysis | Costing Methods | Health Systems | Chronic Disease/Risk | Health/Medicine | Science/Technology | Global -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Mental Health | Social Determinants | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2016What Determines HIV Prevention Costs at Scale?
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, …
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs, and thus, policymakers have little guidance in how best to design programmes that are…
Cost-Effectiveness Analysis | Costing Methods | Health Systems | Infectious Diseases | Global Governance | Economics/Finance | Government/Law | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Cost-Effectiveness Analysis | Costing Methods | Health Systems | Infectious Diseases | Economics/Finance | 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;…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Benefit-Cost Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2016An Economic Evaluation of the PEN Program in Indonesia
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) …
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) introduced the Package of Essential Noncommunicable disease (PEN) interventions. Several countries, including Indonesia, implemented the PEN program. To assess the value of the investment in the current program, an economic evaluation of the program was conducted with collaboration between the Ministry of Health in Indonesia, the WHO, and the International Decision Support Initiative (iDSI). This study evaluated the delivery of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Technology Assessment | Chronic Disease/Risk | Economics/Finance | Government/Law | Health/Medicine | Asia & Pacific