Resources Repository
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ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Technology Assessment | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Government/Law | Economics/Finance | Asia & Pacific | Sub-Saharan Africa | Policy/Regulation | Priority Setting/Ethics | Health Systems | Health/Medicine | Middle East & North Africa | Latin America & Caribbean -
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 | Government/Law | Economics/Finance | Asia & Pacific | Sub-Saharan Africa | Policy/Regulation | Priority Setting/Ethics | Health Systems | Education/Labor | Health/Medicine | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Risk Analysis | Decision Analysis | Dynamic Transmission | Government/Law | Global | Policy/Regulation | Infectious Diseases | Health Systems | Health/Medicine | Science/Technology -
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…
Benefit-Cost Analysis | Cost-Effectiveness Analysis | Economics/Finance | Global | Policy/Regulation | Priority Setting/Ethics | Infectious Diseases | Health/Medicine | North America -
Working PaperPublication 2018Valuing Nonfatal Health Risk Reductions
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- …
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- and middle-income countries. The approach for valuation ideally would be based on estimates of individuals’ willingness to pay for changes in their own risks. However, high quality valuation research is not available for many nonfatal conditions even in high-income settings. Typically, two approaches are used either alone or in combination as rough proxies. The first involves applying an estimate of…
Benefit-Cost Analysis | Decision Analysis | Economics/Finance | Global | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Health Outcomes | Social Determinants | Health/Medicine | Critical Thinking/Analysis -
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 | Government/Law | Europe | Global | Policy/Regulation | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Climate/Environment | Health/Medicine | Science/Technology -
ReviewPublication 2013Valuing the Economic Benefits of Complex Interventions
This is a review of economic evaluations of complex health interventions. Complex interventions, involving interlinked …
This is a review of economic evaluations of complex health interventions. Complex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. The authors find that complex interventions may be problematic on two levels. First, the complexity means the intervention may not fit into one of the current appraisal systems, and/or second, maximizing health is not the only objective. This paper discusses the…
Decision Analysis | Government/Law | Economics/Finance | Europe | Policy/Regulation | Preferences/Values | Health Systems | Health/Medicine | Science/Technology -
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…
Cost-Effectiveness Analysis | Economics/Finance | Global | Policy/Regulation | Health Systems | Health/Medicine -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
Benefit-Cost Analysis | Economics/Finance | Europe | Policy/Regulation | Value of Information | State-Transition | Infectious Diseases | North America