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…
Cost-Effectiveness Analysis | Economics/Finance | Middle East & North Africa | Priority Setting/Ethics | Health Systems | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Europe | 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…
Cost-Effectiveness Analysis | Economics/Finance | Global | Priority Setting/Ethics | Mental Health | Social Determinants | Health Systems | Health/Medicine -
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…
Cost-Effectiveness Analysis | Economics/Finance | Global | Costing Methods | Infectious Diseases | Health Systems | Health/Medicine -
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;…
Cost-Effectiveness Analysis | Economics/Finance | Middle East & North Africa | Priority Setting/Ethics | Health Systems | Policy/Regulation | 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…
Cost-Effectiveness Analysis | Climate/Environment | Global | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology | Europe -
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…
Cost-Effectiveness Analysis | Economics/Finance | Global | Priority Setting/Ethics | Health Systems | Culture/Society | Government/Law | Health/Medicine -
ArticlePublication 2015Achieving a 'Grand Convergence' in Global Health
The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment …
The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment case for a grand convergence in health outcomes globally. In support of the drafting of the Sustainable Development Goals (SDGs), this paper presents estimates of what the grand convergence investment case might achieve—and what investment would be required—by 2030. The authors start with a country-based (bottom-up) analysis of the costs and impact of…!--?xml:namespace prefix = "o" ns = "urn:schemas-microsoft-com:office:office" /-->
Cost-Effectiveness Analysis | Economics/Finance | Global | Costing Methods | Health Outcomes | Health Systems | Global Governance | Health/Medicine | Science/Technology -
ArticlePublication 2010Health and Economic Impact of Rotavirus Vaccination in GAVI-Eligible Countries
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately …
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately borne by children in low-income countries. Motivated by the global recommendation by the WHO that all countries include infant rotavirus vaccination in their national immunization programs, the objective of this analysis was to provide information on the expected health, economic and financial consequences of rotavirus vaccines in the 72 GAVI support-eligible countries. The authors synthesized population-level data from various sources (primarily from…
Cost-Effectiveness Analysis | Economics/Finance | Middle East & North Africa | Health Outcomes | Mathematical Models | State-Transition | Infectious Diseases | Child/Nutrition | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific