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 | Economics/Finance | Sub-Saharan Africa | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Education/Labor | Government/Law | Health/Medicine | 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 | Science/Technology | Europe | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Global -
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…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Cost-Effectiveness Analysis | Health Systems | Health/Medicine -
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…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Food/Agriculture | Health/Medicine -
ArticlePublication 2015Health and Social Protection Effects of Measles Vaccination in Ethiopia: Extended CEA
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different …
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different vaccine delivery strategies in Ethiopia: (1) routine immunization, (2) routine immunization with financial incentives, and (3) mass campaigns, known as supplemental immunization activities (SIAs), for measles vaccination. At higher costs, SIAs reached higher levels of vaccine coverage. Routine immunization paired with financial incentives was found to increase the demand among poorer households.
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Global Governance | Health/Medicine -
ArticlePublication 2015Pneumococcal Vaccination and Pneumonia Treatment in Ethiopia: Results from Extended CEA
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully …
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully publicly financed interventions in Ethiopia: pneumococcal vaccination for newborns and pneumonia treatment for under-five children. The authors apply ECEA methods and estimate the program impact on: (1) government program costs; (2) pneumonia and pneumococcal deaths averted; (3) household expenses related to pneumonia/pneumococcal disease treatment averted; (4) prevention of household medical impoverishment; and (5) distributional consequences across the wealth strata of…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Health/Medicine -
ArticlePublication 2015Extended CEA: Surgical Access in Ethiopia
This chapter presents an extended cost-effectiveness analysis of strategies to improve access to surgical care …
This chapter presents an extended cost-effectiveness analysis of strategies to improve access to surgical care in rural Ethiopia, providing information on the health and financial risk protection benefits of policies. This chapter is from Essential Surgery, the first volume in the Disease Control Priorities, third edition (DCP3) series. The volume presents data on the surgical burden of disease, disability, congenital anomalies, and trauma, along with health impact and economic analyses of procedures, platforms, and packages…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Costing Methods | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Health/Medicine -
ArticlePublication 2012Health and Economic Outcomes of Interventions to Reduce Pregnancy-Related Mortality in Nigeria
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed …
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed to reduce maternal mortality in Nigeria, a country with extremely high maternal mortality rates. Using a previously validated model adapted to the Nigerian context, the study finds that an increase of access to family planning is the most effective individual strategy, which not only reduces pregnancy-related mortality but also proves to be economically efficient. However, relying solely on family planning…
Health Outcomes | Economics/Finance | Sub-Saharan Africa | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health Systems | Policy/Regulation | Health/Medicine