Resources Repository
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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 | Policy/Regulation | Cost-Effectiveness Analysis | 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 | Policy/Regulation | Cost-Effectiveness Analysis | 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 | Policy/Regulation | Evidence Synthesis | Cost-Effectiveness Analysis | Health/Medicine | Global -
ArticlePublication 2016“Nudges” in Law and Policy
This article describes research on Americans’ preferences for types of “nudges” in the context of …
This article describes research on Americans’ preferences for types of “nudges” in the context of law and public policy—those that target “system 1” thinking, meaning the intuitive, emotion-based mechanisms, such as graphic warnings and default rules, versus those that target “system 2” thinking, the rational, deliberative form of cognition, such as statistical information or education-based messages.
Priority Setting/Ethics | Policy/Regulation | Decision Psychology | Preferences/Values | Culture/Society | Government/Law | Health/Medicine -
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 | Policy/Regulation | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Population Health Model (POHEM): An Overview
This paper provides an overview of the rationale, methodology and applications of the Population Health …
This paper provides an overview of the rationale, methodology and applications of the Population Health Model (POHEM). POHEM is a health microsimulation model, developed at Statistics Canada in the early 1990s. The authors describe that POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals’ disease states, risk factors, and health determinants, in order…
Mathematical Models | Policy/Regulation | Costing Methods | Evidence Synthesis | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Priority Setting/Ethics | Policy/Regulation | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2011Dynamic Policies for Controlling Spread of Emerging Infections
This paper illustrates the design and implementation of a dynamic health policy for the control …
This paper illustrates the design and implementation of a dynamic health policy for the control of a novel strain of influenza, where two types of interventions are assumed to be available during the epidemic: (1) vaccines and antiviral drugs, and (2) transmission reducing measures, such as social distancing or mask use, that may be turned "on" or "off" repeatedly during the course of epidemic. A modeling approach is described for developing dynamic health policies that allow…
Mathematical Models | Policy/Regulation | Dynamic Transmission | Dynamic Simulation | Infectious Diseases | Health Systems | Health/Medicine | Science/Technology | Global