Resources Repository
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ArticlePublication 2018HTA and MCDA Solely or Combined? The Case of Priority-Setting in Colombia
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related …
Given the limited resources available worldwide, healthcare systems face problems of justice and efficiency related to setting priorities. Two methods, Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as tools to assist in informed decision-making, but both have advantages and disadvantages. Colombia established a Health Technology Assessment Institute in 2012. The authors discuss challenges faced by the Colombian health system, characteristics of HTA in Colombia and the potential benefits and drawbacks of…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Health Systems | Health/Medicine | Latin America & Caribbean -
ReportPublication 2018Estimating the Distributional Impact of Increasing Taxes on Tobacco Products in Armenia
Smoking is considered the leading risk factor for mortality among the Armenian population. The authors …
Smoking is considered the leading risk factor for mortality among the Armenian population. The authors conducted an extended cost-effectiveness analysis (ECEA) on increases in the excise tax on cigarettes in Armenia. Based on the World Health Organization recommendations, they analyzed the impact of a 75% increase of excise tax on the retail price of cigarettes. The ECEA found large health and financial benefits to the excise tax. It averted about 88,000 premature deaths, US$63 million of OOP…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Chronic Disease/Risk | Health Systems | Business/Industry | Economics/Finance | Government/Law | Health/Medicine | Europe -
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 | Policy/Regulation | Preferences/Values | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Chronic Disease/Risk | Social Determinants | Environmental Health | Climate/Environment | Economics/Finance | Energy/Engineering | 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;…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Policy/Regulation | Evidence Synthesis | Health/Medicine | Global -
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 | Policy/Regulation | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems | Health/Medicine | Sub-Saharan Africa -
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 | Policy/Regulation | Costing Methods | Chronic Disease/Risk | Health Systems | Economics/Finance | Food/Agriculture | Health/Medicine | Sub-Saharan Africa