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 2015Valuing Regulations Affecting Addictive or Habitual Goods
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies …
The analysis of regulations affecting addictive or habitual goods has drawn considerable controversy. Some studies have suggested that such regulations have only small welfare benefits, as consumers value these goods despite health benefits from quitting, while other studies suggest that information or behavioral problems make existing consumption decisions a poor guide to welfare evaluation. This analysis examines potential utility offsets to health benefits of regulations affecting addictive or habitual goods theoretically and empirically. The paper…
Preferences/Values | Policy/Regulation | Benefit-Cost Analysis | Chronic Disease/Risk | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | North America -
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 | Policy/Regulation | Mathematical Models | Cost-Effectiveness Analysis | 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 | Policy/Regulation | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
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 2013Using Occupational Injury Data to Estimate VSL
This article discusses the use of occupational fatality rate data to estimate the additional pay …
This article discusses the use of occupational fatality rate data to estimate the additional pay workers receive for bearing greater risks, while controlling for other aspects of the job and characteristics of the worker. This tradeoff rate is typically referenced as the value of a statistical life (VSL). The extensive U.S. labor market literature generating VSL estimates has utilized several fatality rate measures which are typically matched to employment information on workers from large datasets.…
Preferences/Values | Policy/Regulation | Benefit-Cost Analysis | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2013Valuing Health Risk Reductions
In this article, the authors discuss how to value risk reductions in the context of …
In this article, the authors discuss how to value risk reductions in the context of benefit-cost analysis. Many public policies and private actions affect the risk of injury, illness, or death, yet changes in these risks are not easily valued using market prices. The authors begin with a pragmatic focus, describing the analytic framework and the approaches currently used for valuation, including estimates of willingness to pay (WTP), cost of illness (COI), and monetized quality-adjusted…
Preferences/Values | Policy/Regulation | Benefit-Cost Analysis | College | Graduate | Critical Thinking/Analysis -
ArticlePublication 2012Expert Elicitation of VSL
This article uses expert elicitation to address the monetary value of avoided premature mortality, which …
This article uses expert elicitation to address the monetary value of avoided premature mortality, which typically dominates the quantified benefits of air pollution regulations. Formal expert elicitation methods are one means of characterizing associated uncertainties. The authors undertake a pilot study that elicits quantitative probabilistic judgments of uncertainties in value per statistical life (VSL) estimates for use in an air pollution context. The two-stage elicitation addresses uncertainties in both a base case VSL for a…
Preferences/Values | Policy/Regulation | Benefit-Cost Analysis | Climate/Environment | College | Graduate | Critical Thinking/Analysis