Resources Repository
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ArticlePublication 2017Valuing Non-Fatal Risks: Monetary and Health-Utility Measures
This article discusses metrics for valuing environmental, health, and safety policies, which should be consistent …
This article discusses metrics for valuing environmental, health, and safety policies, which should be consistent with both the preferences of affected individuals and social preferences for distribution of health risks in the population. Two classes of metrics are widely used: monetary measures (e.g., willingness to pay) and health-utility measures (e.g., quality-adjusted life years (QALYs), disability-adjusted life years (DALYs)). Health-utility measures impose more structure than monetary measures, with the result that individuals’ preferences often appear inconsistent…
Benefit-Cost Analysis | Policy/Regulation | Preferences/Values | Climate/Environment | College | Graduate | Critical Thinking/Analysis -
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…
Cost-Effectiveness Analysis | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Health Systems | Health/Medicine | Global -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Chronic Disease/Risk | Social Determinants | Environmental Health | Climate/Environment | Economics/Finance | Energy/Engineering | Science/Technology | Asia & Pacific -
ArticlePublication 2017Cost-Effectiveness of a Policy Strategy to Decrease Sodium Intake: Global Analysis
The objective of this study was to assess the cost effectiveness of a government policy combining …
The objective of this study was to assess the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. To account for heterogeneity in efficacy across countries, a range of scenarios were evaluated, including 10%, 30%, 0.5 g/day, and 1.5 g/day sodium reductions achieved over 10 years. Country specific costs of a sodium reduction policy were estimated using the WHO Noncommunicable Disease Costing Tool. Country…
Cost-Effectiveness Analysis | Policy/Regulation | Child/Nutrition | Chronic Disease/Risk | Social Determinants | Food/Agriculture | Government/Law | Health/Medicine | Global -
ArticlePublication 2016Health, Financial and Distributional Consequences of Tobacco Excise Tax in Lebanon
This paper considers the financial and health effects, by socio-economic class, of increasing tobacco taxes …
This paper considers the financial and health effects, by socio-economic class, of increasing tobacco taxes in Lebanon, a middle-income country. Extended cost-effectiveness analysis (ECEA) methods are applied to quantify, across quintiles of socio-economic status, the health benefits gained, the additional tax revenues raised, and the net financial consequences for households from a 50% increase in the price of tobacco through excise taxes. The increase in tobacco tax is estimated to result in 65,000 premature deaths…
Cost-Effectiveness Analysis | Policy/Regulation | Costing Methods | Chronic Disease/Risk | Health/Medicine | Middle East & North Africa -
GuidelinesPublication 2016Decision Models in Clinical Preventive Services Recommendations
The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about preventive care based on …
The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about preventive care based on comprehensive systematic reviews of the best available evidence. Decision models provide a complementary, quantitative approach to support the USPSTF as it deliberates about the evidence and develops recommendations for clinical and policy use. This article describes the rationale for using modeling, an approach to selecting topics for modeling, and how modeling may inform recommendations about clinical preventive services.
Decision Analysis | Policy/Regulation | Health Outcomes | Evidence Synthesis | Mathematical Models | Health Systems | Health/Medicine | North America -
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 | Policy/Regulation | Priority Setting/Ethics | Health Systems | 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 | Policy/Regulation | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Evidence Synthesis | Health/Medicine | Global