Resources Repository
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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/Medicine | Climate/Environment | Global | Policy/Regulation | Chronic Disease/Risk | Health Systems | Government/Law | Science/Technology | Europe -
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 | Health/Medicine | Global | Policy/Regulation | Benefit-Cost Analysis | Infectious Diseases | Economics/Finance | North America -
ArticlePublication 2018Consequences of a Cigarette Price Increase in 13 Middle Income Countries
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in …
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in market prices of cigarettes on health, poverty, and financial protection for men in 13 middle income countries. A 50% increase in cigarette prices would lead to about 450 million years of life gained across the 13 countries from smoking cessation, with half of these in China. Across all countries, men in the bottom income group would gain 6.7 times more…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Global | Policy/Regulation | Mathematical Models | Chronic Disease/Risk | Social Determinants -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Global | Policy/Regulation | Preferences/Values | Health Systems -
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/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Economics/Finance | Education/Labor | Government/Law | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Global | Policy/Regulation | Evidence Synthesis -
ArticlePublication 2015Health Gains & Financial Risk Protection by Public Financing in Ethiopia: An ECEA
This article, published in the Lancet Global Health, aims to evaluate the health and financial …
This article, published in the Lancet Global Health, aims to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. The authors used an extended cost-effectiveness analysis (ECEA) to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine interventions that the Government of Ethiopia aims to make universally available. This approach incorporates financial…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems -
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 | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Costing Methods | Chronic Disease/Risk | Health Systems | Economics/Finance | Food/Agriculture -
ArticlePublication 2024Extended Cost-Effectiveness Analysis of Interventions to Improve Uptake of Diabetes Services in South Africa
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes …
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes diagnosis and treatment service utilization in South Africa (SA) using extended cost-effectiveness analysis (ECEA). Applying a Markov model over a 45-year period, the analysis compares costs, health benefits, and financial risk protection (FRP) attributes of different CCT strategies, drawing from SA-specific data. Three scenarios were simulated: covering diagnosis services only, treatment services only, and both diagnosis and treatment services. Cost-effectiveness,…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Outcomes | Mathematical Models | Chronic Disease/Risk