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 | Middle East & North Africa | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan 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 | Global | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Priority Setting/Ethics | Global | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health Systems | Economics/Finance | Health/Medicine -
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 | Global | Evidence Synthesis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine -
ArticlePublication 2016Universal Health Coverage as a Pathway to the Sustainable Development Goals
The inclusion of universal health coverage (UHC) as a target in the health Sustainable Development …
The inclusion of universal health coverage (UHC) as a target in the health Sustainable Development Goals speaks to its importance as both a foundational and an end goal for global health. Across the globe, countries are in varying stages of progress toward UHC. To help countries where there is a wide gap between the reality of limited access and the aspirations of universality, the author argues that there must be prioritized investments to progressively realize…
Priority Setting/Ethics | Global | Social Determinants | Health Systems | Global Governance | Health/Medicine -
ArticlePublication 2016Defining a Health Benefits Package: What Are the Necessary Processes?
There is immense interest worldwide in the notion of universal health coverage. A major policy …
There is immense interest worldwide in the notion of universal health coverage. A major policy focus in moving toward universal health coverage has been on the key policy question: what services should be made available and under what conditions? This article focuses on how a feasible set of universal health coverage services can be explicitly defined to create what is commonly known as a “health benefits package”, a set of services that can be feasibly financed…
Priority Setting/Ethics | Global | Cost-Effectiveness Analysis | Health Systems | Culture/Society | Economics/Finance | Government/Law | Health/Medicine -
GuidelinesPublication 2014Methods for Economic Evaluation Project
This report details the work of the Methods for Economic Evaluation Project (MEEP), which aims …
This report details the work of the Methods for Economic Evaluation Project (MEEP), which aims to promote a consistency in the methods used for economic evaluations. The report is targeted especially at low and middle-income countries (LMICs). The Bill and Melinda Gates Foundation is a major funder of health economic evaluations in LMICs, but there is substantial variation in the methods used and the quality of the analyses produced. The report drew on expertise from…
Priority Setting/Ethics | Global | Costing Methods | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Climate/Environment | Education/Labor | Health/Medicine -
ArticlePublication 2013Estimated Mortality Impact of Vaccinations 2011–2020 in 73 GAVI Alliance Countries
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted …
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted by the GAVI Alliance and the Bill & Melinda Gates Foundation to estimate the impact of vaccination in 73 countries supported by the GAVI Alliance. The number of deaths averted in persons projected to be vaccinated during 2011–2020 was estimated for ten antigens: hepatitis B, yellow fever, Haemophilus influenzae type B (Hib), Streptococcus pneumoniae, rotavirus, Neisseria meningitidis serogroup A, Japanese…
Microsimulation | Middle East & North Africa | Health Outcomes | Mathematical Models | State-Transition | Dynamic Transmission | Infectious Diseases | Global Governance | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific