Resources Repository
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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 | Global | Policy/Regulation | Priority Setting/Ethics | Infectious Diseases | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Policy/Regulation | Health/Medicine -
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…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Policy/Regulation | Priority Setting/Ethics | Health/Medicine -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Health Outcomes | Global | Policy/Regulation | Infectious Diseases | Maternal/Reproductive Health | Health/Medicine -
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 | Global | Policy/Regulation | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2021COVID-19 Mortality and Self-Imposed Behavior Change/Government Regulations
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country …
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country comparison could indicate the relative efficacy of these approaches. This article assesses various nonpharmaceutical interventions, comparing the effects of voluntary behavior change and of changes enforced via official regulations, by examining their impacts on subsequent death rates. Voluntarily reduced mobility, occurring prior to government policies, decreases the percent change in deaths per day by 9.2% (95% confidence interval [CI] 4.5–14.0).…
Health Outcomes | Global | Policy/Regulation | Infectious Diseases -
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…
Cost-Effectiveness Analysis | Global | Policy/Regulation | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Social Determinants | Health/Medicine -
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…
Dynamic Transmission | Global | Policy/Regulation | Decision Analysis | Risk Analysis | Infectious Diseases | Health Systems | Government/Law | Health/Medicine | Science/Technology -
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 | Global | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Health Systems | Health/Medicine