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 | Cost-Effectiveness Analysis | Government/Law | Education/Labor | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Broader Economic Impact of Vaccination: Reviewing and Appraising the Strength of Evidence
Economic evaluations of public health programs such as immunization often consider only direct health benefits and …
Economic evaluations of public health programs such as immunization often consider only direct health benefits and medical cost savings. Evidence linking immunization to important benefits in indicators such as childhood development, household behavior, and other macro-economic data are unclear. A conceptual framework of the pathways between immunization and these broader economic benefits was developed through expert consultation. The authors obtained articles from previous reviews, snowballing, and expert consultation, and associated them with one of the pathways and assessed them using modified Grading…
Priority Setting/Ethics | Preferences/Values | Cost-Effectiveness Analysis | Education/Labor | Costing Methods | Evidence Synthesis | Benefit-Cost Analysis | Infectious Diseases | Social Determinants | Economics/Finance | Health/Medicine -
ReviewPublication 2006Ethical Issues in Resource Allocation, Research, and New Product Development
Ethical dilemmas arising in setting priorities among interventions and among individuals in need of care …
Ethical dilemmas arising in setting priorities among interventions and among individuals in need of care are most acute when needs are great and resources few. This chapter from the Disease Control Priorities in Developing Countries 2nd edition addresses some of these concerns, identifying some of the principal ethical issues that arise in the development and allocation of effective interventions for developing countries and discussing some alternative resolutions. Resource allocation in health and elsewhere should satisfy two main…
Priority Setting/Ethics | Preferences/Values | Cost-Effectiveness Analysis | Government/Law | Culture/Society | Health/Medicine | Science/Technology -
ArticlePublication 2021COVID-19, Fake News, and Vaccines: Should Regulation Be Implemented?
This article analyzes issues concerning the establishment of compulsory vaccination against COVID-19, as well as …
This article analyzes issues concerning the establishment of compulsory vaccination against COVID-19, as well as the role of misinformation as a disincentive – especially when published by health professionals – and citizen acceptance of measures in this regard. Data from different surveys revealed a high degree of hesitation rather than outright opposition to vaccines. The most frequent complaint related to the COVID-19 vaccination was the fear of side effects. Within the Spanish and European legislative…
Preferences/Values | Government/Law | Education/Labor | Decision Psychology | Infectious Diseases | Social Determinants | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | Global -
ArticlePublication 2020New Fronts in the War on Misinformation
The countless false claims that have spread alongside the novel coronavirus – inaccurate advice about …
The countless false claims that have spread alongside the novel coronavirus – inaccurate advice about how to prevent the virus, for example, and conspiracy theories about its origins – are just the latest manifestation of an ongoing problem: the online proliferation of misinformation about science and health. The National Academies hosted and helped organize three events focused on countering misinformation: The MisinfoCon conference, a Wikipedia Edit-a-thon, and a meeting to explore ways to expand successful…
Preferences/Values | Government/Law | Education/Labor | Decision Psychology | Infectious Diseases | Social Determinants | Policy/Regulation | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Government/Law | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Global -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Education/Labor | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Government/Law | Benefit-Cost Analysis | Technology Assessment | Health Systems | Policy/Regulation | Economics/Finance | 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 | Government/Law | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Health/Medicine | Science/Technology | Global | Europe