Resources Repository
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ArticlePublication 2017Getting it Right When Budgets are Tight: Prioritizing Responses to HIV Epidemics
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and …
Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain.The authors examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Costing Methods | Mathematical Models | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Preferences/Values | Health Systems | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Social Determinants | Environmental Health | Policy/Regulation | Climate/Environment | Economics/Finance | Energy/Engineering | Science/Technology | Asia & Pacific -
ArticlePublication 2017Reduced Burden of Childhood Diarrheal Diseases through Increased Access to Water and Sanitation in India: Modeling Analysis
This analysis estimates the health and economic benefits of scaling up the coverage of piped …
This analysis estimates the health and economic benefits of scaling up the coverage of piped water and improved sanitation to a near-universal 95% level among Indian households. The authors used an agent-based microsimulation platform, IndiaSim, to model disease progression and individual healthcare-seeking behavior in India, and use ECEA to estimate health and economic outcomes over time. They found that scaling up access to piped water and improved sanitation could avert 43,352 diarrheal episodes and 68…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Costing Methods | Health Outcomes | Microsimulation | Child/Nutrition | Social Determinants | Environmental Health | Economics/Finance | Energy/Engineering | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2016Economic Evaluation: Bibliometric Analysis of Recent Literature
This bibliometric analysis focuses on recently published full economic evaluations of health interventions and reflects …
This bibliometric analysis focuses on recently published full economic evaluations of health interventions and reflects critically on the implications of the findings. The authors created a database drawing on 14 health, economic, and/or general literature databases for articles published between 1 January 2012 and 3 May 2014 and identified 2844 economic evaluations. They examined the distribution of publications between countries, regions, and health areas studied and compared the relative volume of research with disease burden.…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Benefit-Cost Analysis | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Mathematical Models | Operations Research | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Cost-Effectiveness Thresholds: Pros and Cons
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. …
This WHO bulletin compares the two main methods for comparing the cost-effectiveness of health interventions. Cost-effectiveness thresholds allow health decision makers to identify cost-effectiveness ratios that represent good or bad value for money. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, these thresholds have been used as decision rules. However, this approach lacks country specificity…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Health/Medicine