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;…
Government/Law | Economics/Finance | Asia & Pacific | Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Education/Labor | Health/Medicine | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2016Country-Level Cost-Effectiveness Thresholds
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income …
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four…
Economics/Finance | Asia & Pacific | Europe | Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2023Benefits and Costs of COVID-19 Vaccine Mandates
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations …
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations for U.S. federal employees and healthcare and private sector workers. These mandates were controversial and some were halted by litigation. If they had been implemented as intended, the net benefits would depend on the course of the pandemic. If a more transmissible variant (such as Omicron) emerges, the net benefits may be large. If the pandemic instead fades, the benefits…
Government/Law | Economics/Finance | North America | Mathematical Models | State-Transition | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation | Business/Industry | Health/Medicine -
ArticlePublication 2022Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face …
The COVID-19 pandemic necessitated time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. This study aimed to quantify consequences of approving therapies or pursuing further research. The authors used a cohort state-transition model for hospitalized patients with COVID-19 to estimate quality-adjusted life-years (QALYs) and costs associated with multiple drug regimens and usual care. For each they assessed immediate approval, use only in research, emergency use authorization or reject. They conducted cost-effectiveness…
Economics/Finance | Europe | North America | Value of Information | State-Transition | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation -
ArticlePublication 2013Nutritional Policy Changes in SNAP: A Microsimulation and Cost-Effectiveness Analysis
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) …
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) or subsidizing fruits and vegetables purchased with SNAP. The target population was adults in the U.S. and the time horizon was 10 years. Results showed that banning SSB purchases using SNAP benefits would be expected to avert 510,000 diabetes person-years and 52,000 deaths from MIs and strokes over the next decade, with a savings of $2900 per QALY saved. A…
Government/Law | Economics/Finance | North America | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Food/Agriculture | Health/Medicine -
ArticlePublication 2019Cost-Effectiveness of U.S. National SSB Tax with a Multistakeholder Approach: Who Pays and Who Benefits
This analysis estimated the health impact and cost-effectiveness of a national penny-per-ounce sugar-sweetened beverage (SSB) …
This analysis estimated the health impact and cost-effectiveness of a national penny-per-ounce sugar-sweetened beverage (SSB) tax, overall and with stratified costs and benefits for nine distinct stakeholder groups. A microsimulation model (CVD PREDICT) was used to estimate cardiovascular disease reductions, quality-adjusted life years gained, and cost-effectiveness for U.S. adults aged 35 to 85 years, evaluating full and partial consumer price pass-through. Results showed that from both a health care and societal perspective, the SSB tax was…
Government/Law | Economics/Finance | North America | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Business/Industry | Health/Medicine -
ArticlePublication 2019Health Impact and Cost-Effectiveness of SSB Taxes for Reducing Cancer Burden in the U.S.
This analysis evaluated the health outcomes, costs, and cost-effectiveness of a national sugar-sweetened beverage (SSB) …
This analysis evaluated the health outcomes, costs, and cost-effectiveness of a national sugar-sweetened beverage (SSB) tax policy for reducing obesity-related cancer in the U.S. A probabilistic cohort state-transition model, the Diet Cancer Outcome Model (DiCOM), was used to project the effect of a national $0.01 per ounce SSB excise tax on 13 obesity-associated cancers among U.S. adults age 20 and older over their lifetime. Cost-effectiveness was evaluated using both government affordability and societal perspectives. Results showed…
Government/Law | Economics/Finance | North America | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Health/Medicine -
ArticlePublication 2018Cost-Effectiveness of Financial Incentives and Disincentives for Improving Food Purchases and Health through SNAP
This analysis estimated the health impact, costs, and cost-effectiveness of food incentives, disincentives, or restrictions …
This analysis estimated the health impact, costs, and cost-effectiveness of food incentives, disincentives, or restrictions in the Supplemental Nutrition Assistance Program (SNAP). A microsimulation model (CVD-PREDICT) was used to compare three policy interventions: (1) a 30% incentive for fruits and vegetables (F&V), (2) a 30% F&V incentive with a restriction of sugar-sweetened beverages (SSBs), and (3) a broader incentive/disincentive program for multiple foods that also preserves choice (SNAP-plus). From a societal perspective, all three scenarios…
Government/Law | Economics/Finance | North America | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Business/Industry | Health/Medicine -
ArticlePublication 2017Catastrophic Costs Potentially Averted by TB Control in India and South Africa
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis …
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis services in India and South Africa from 2016 to 2035, in line with the End TB Strategy. The authors investigated three intervention scenarios: improved treatment of drug-sensitive tuberculosis; improved treatment of multidrug-resistant tuberculosis; and expansion of access to tuberculosis care through intensified case finding (South Africa only). In India and South Africa, improvements in treatment for drug-sensitive and multidrug-resistant tuberculosis…
Economics/Finance | Asia & Pacific | Sub-Saharan Africa | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Health Systems | Health/Medicine