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 | Europe | Middle East & North Africa | Priority Setting/Ethics | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific -
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…
Evidence Synthesis | Health Outcomes | Middle East & North Africa | Chronic Disease/Risk | Health Systems | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2016Essential Package of Cancer Control: Costs, Affordability, and Feasibility of an Essential Package of Cancer Control Interventions in LMIC Countries
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in …
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Disease Control Priorities, 3rd edition developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of…
Cost-Effectiveness Analysis | Costing Methods | Global | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology -
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 | Costing Methods | Global | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine -
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 | Europe | Global | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Evidence Synthesis | Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Policy/Regulation | Health/Medicine -
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 | Health Outcomes | Middle East & North Africa | Mathematical Models | State-Transition | Infectious Diseases | Child/Nutrition | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2008Economic Burden of Personality Disorders in Mental Health Care
This paper aimed to investigate the economic burden of patients with personality disorders in mental …
This paper aimed to investigate the economic burden of patients with personality disorders in mental health care. The direct and indirect costs were assessed for 1740 study participants with a clinical diagnosis of personality disorders using the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. Results indicated that the mean total costs in the 12 months prior to treatment were €11,126 per patient. Two thirds (66.5%) of these costs consisted…
Evidence Synthesis | Costing Methods | Europe | Mental Health | Health/Medicine