Resources Repository
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ArticlePublication 2016Cost-Effectiveness Thresholds: Pros and Cons
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. …
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. Cost-effectiveness thresholds allow health decision makers to identify cost-effectiveness ratios that represent good or bad value for money. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, these thresholds have been used as decision rules. However, this approach lacks country specificity…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Health/Medicine -
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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Culture/Society | Health/Medicine -
ArticlePublication 2016An Extended CEA of Schizophrenia Treatment in India under Universal Public Finance
This paper evaluates the potential health and financial risk protection effects of a policy of …
This paper evaluates the potential health and financial risk protection effects of a policy of universal public finance (UPF) to treating schizophrenia in India. The study uses the extended cost effectiveness analysis framework across income quintiles. The results show financial protection benefits concentrated in the richest income quintiles, while health gains were concentrated among the poorest. The value of insurance is highest for the poorest income and decreases as the household income increases. In settings…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Costing Methods | Mental Health | Clinical Care | Culture/Society | Economics/Finance | Health/Medicine | Asia & Pacific -
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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Mental Health | Social Determinants | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2016Rotavirus Vaccines Contribute Towards UHC in A Mixed Public–Private Healthcare System
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from …
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from the household’s perspective. The authors found that rotavirus vaccination reduces rotavirus episodes and expenditure substantially and provides financial risk protection to all income groups. Although the rich are paying more out of pocket than the poor by utilizing more expensive healthcare, the poor are paying more in proportion to household income. Poverty reduction benefits are concentrated amongst the poorest two…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Child/Nutrition | Social Determinants | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
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;…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Chronic Disease/Risk | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
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…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Technology Assessment | Chronic Disease/Risk | Economics/Finance | Government/Law | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Defining a Health Benefits Package: What Are the Necessary Processes?
There is immense interest worldwide in the notion of universal health coverage. A major policy …
There is immense interest worldwide in the notion of universal health coverage. A major policy focus in moving toward universal health coverage has been on the key policy question: what services should be made available and under what conditions? This article focuses on how a feasible set of universal health coverage services can be explicitly defined to create what is commonly known as a “health benefits package”, a set of services that can be feasibly financed…
Cost-Effectiveness Analysis | Health Systems | Priority Setting/Ethics | Culture/Society | Economics/Finance | Government/Law | Health/Medicine | Global