Resources Repository
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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…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Assessing Medical Impoverishment by Cause
This article, published in BMC Medicine, utilizes a cost and epidemiological model to propose an …
This article, published in BMC Medicine, utilizes a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia (i.e., the number of households crossing a poverty line due to out-of-pocket (OOP) direct medical expenses). Among 20 leading causes of mortality, the authors estimate the burden of medical impoverishment to be around 350,000 poverty cases, with the top three causes of medical impoverishment attributed to diarrhea, lower respiratory infections, and…
Costing Methods | Sub-Saharan Africa | Health Systems | Health/Medicine -
ArticlePublication 2016Cost-Effectiveness of Diagnosing HIV Infection During Early Infancy in South Africa
In this study the clinical impact and cost-effectiveness of four different early infant HIV diagnosis …
In this study the clinical impact and cost-effectiveness of four different early infant HIV diagnosis (EID) testing strategies for HIV-exposed infants in South Africa were compared using a microsimulation model. The strategies included (1) no EID (diagnosis only after illness), (2) and (3) testing once (at birth alone or at 6 weeks of age alone), and (4) testing twice (at birth and 6 weeks of age). Findings showed that the testing at birth alone strategy…
Microsimulation | Sub-Saharan Africa | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Health/Medicine -
ArticlePublication 2016Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and …
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, the authors reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Using a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement…
Health Outcomes | Sub-Saharan Africa | Evidence Synthesis | Chronic Disease/Risk | Health Systems | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | 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.…
Sub-Saharan Africa | Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Technology Assessment | Health Systems | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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;…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine -
ReviewPublication 2015Provider Costs for Cardiovascular Disease in Low-And Middle-Income Countries: A Systematic Review
The burden of cardiovascular disease (CVD) and related conditions is increasing in low- and middle-income countries. Policy …
The burden of cardiovascular disease (CVD) and related conditions is increasing in low- and middle-income countries. Policy makers need an understanding of the magnitude and drivers of the costs of cardiovascular disease related conditions to make decisions on how to allocate limited health resources. This systematic review of the published literature documents provider-incurred costs of treatment for cardiovascular diseases and risk conditions in low- and middle-income countries. Total costs of treatment were inflated to 2012 US dollars for comparability…
Costing Methods | Sub-Saharan Africa | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Cost-Effectiveness of First-Line Antiretroviral Therapy for HIV-Infected African Children Less Than 3 Years of Age
This article compares the cost-effectiveness of different strategies of first-line antiretroviral therapy (no ART, first-line nevirapine …
This article compares the cost-effectiveness of different strategies of first-line antiretroviral therapy (no ART, first-line nevirapine with second-line lopinavir/ritonavir, and first-line lopinavir/ritonavir with second-line nevirapine) for HIV-infected children less than 3 years of age in Africa, using the Cost-Effectiveness of Preventing AIDS Complications- Pediatric model and data obtained from the International Maternal, Pediatric, and Adolescent Clinical Trial P1060 trial. Results demonstrated that both ART regimens were very cost-effective compared to no ART. First-line lopinavir/ritonavir led to longer…
Microsimulation | Sub-Saharan Africa | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Health/Medicine