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;…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Evidence Synthesis | Health/Medicine | Global -
ArticlePublication 2015Three Interventions That Reduce Childhood Obesity
Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. …
Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. The authors estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: (1) a sugar-sweetened beverage excise tax, (2) elimination of the tax subsidy for advertising unhealthy food to children, (3) restaurant menu calorie labeling, (4) nutrition standards for school meals, (5) nutrition standards for all other food and beverages sold in schools, (6) improved early care and…
Cost-Effectiveness Analysis | Policy/Regulation | Costing Methods | Child/Nutrition | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | North America -
ReviewWeb Portal 2015Science of Making Better Decisions About Health: CEA and BCA
This chapter reviews the main scientific methods for guiding the allocation of resources to health: cost-effectiveness …
This chapter reviews the main scientific methods for guiding the allocation of resources to health: cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA), sketches their methodological progress over the last several decades, and presents examples of how medical practice in other high-income countries, where people live longer, follows the priorities indicated by cost-effectiveness analysis.
Cost-Effectiveness Analysis | Policy/Regulation | Benefit-Cost Analysis | Health Systems | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Costing Methods | 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…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Costing Methods | Health Outcomes | Infectious Diseases | Social Determinants | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Asia & Pacific -
ReviewPublication 2015Medicare's Use of CEA for Prevention (But Not Treatment)
Medicare currently pays for 23 preventive services in its benefits package, the majority of which …
Medicare currently pays for 23 preventive services in its benefits package, the majority of which were added since 2005. In the past decade, the program has transformed from one essentially administering treatment claims, to one increasingly focused on health promotion and maintenance. What is largely unappreciated is the role cost-effectiveness analysis has played in the coverage of preventive services. This study reviews the role of cost-effectiveness analysis in Medicare coverage of preventive services and contrast it…
Cost-Effectiveness Analysis | Policy/Regulation | Priority Setting/Ethics | Technology Assessment | Infectious Diseases | Child/Nutrition | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | North America