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…
Economics/Finance | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
ArticlePublication 2016Health Gains & Financial Protection from Ethiopian Mental Health Strategy: An ECEA
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed …
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed care for depression, bipolar disorder, schizophrenia and epilepsy as part of the mental and neurological package (MN) of the National Mental Health Strategy in Ethiopia. The following outcomes were estimated disaggregated across wealth quintiles: (1) healthy-life-years (HALYs) gained; (2) household out-of-pocket (OOP) expenditures averted (3) expected financial risk protection (FRP); and (4) productivity impact. The MN package is expected to…
Economics/Finance | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Mental Health | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016An Extended CEA of Schizophrenia Treatment in India under Universal Public Finance
This paper evaluates the potential health and financial risk protection effects of a policy of …
This paper evaluates the potential health and financial risk protection effects of a policy of universal public finance (UPF) to treating schizophrenia in India. The study uses the extended cost effectiveness analysis framework across income quintiles. The results show financial protection benefits concentrated in the richest income quintiles, while health gains were concentrated among the poorest. The value of insurance is highest for the poorest income and decreases as the household income increases. In settings…
Economics/Finance | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Mental Health | Health Systems | Clinical Care | Culture/Society | Health/Medicine | Asia & Pacific -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Economics/Finance | Priority Setting/Ethics | Cost-Effectiveness Analysis | Mental Health | Social Determinants | Health Systems | Health/Medicine | Global -
ArticlePublication 2016Rotavirus Vaccines Contribute Towards UHC in A Mixed Public–Private Healthcare System
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from …
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from the household’s perspective. The authors found that rotavirus vaccination reduces rotavirus episodes and expenditure substantially and provides financial risk protection to all income groups. Although the rich are paying more out of pocket than the poor by utilizing more expensive healthcare, the poor are paying more in proportion to household income. Poverty reduction benefits are concentrated amongst the poorest two…
Economics/Finance | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2016What Determines HIV Prevention Costs at Scale?
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, …
Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs, and thus, policymakers have little guidance in how best to design programmes that are…
Economics/Finance | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Global Governance | Government/Law | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Economics/Finance | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Health/Medicine | Global -
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;…
Economics/Finance | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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…
Economics/Finance | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Culture/Society | Government/Law | Health/Medicine | Global