Resources Repository
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ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Dynamic Transmission | Decision Analysis | Risk Analysis | Infectious Diseases | Health Systems | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2017Revealed Willingness-to-Pay vs. Standard Cost-Effectiveness Thresholds
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The …
This study estimates the cost-effectiveness thresholds (CETs) of 16 HIV programs in South Africa. The use of CETs based on a country’s income per capita has been criticized for not being grounded in theory or evidence, especially in low and middle-income countries (LMICs). An alternative has been produced for South Africa, based on estimates of life years saved and the country’s committed HIV budget. The authors used a previously -published optimization method to estimate CETs,…
Priority Setting/Ethics | Preferences/Values | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
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 | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | 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 | Costing Methods | Cost-Effectiveness Analysis | 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 | Preferences/Values | Cost-Effectiveness Analysis | 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 | Costing Methods | Health Outcomes | Microsimulation | Cost-Effectiveness Analysis | Child/Nutrition | Social Determinants | Environmental Health | Economics/Finance | Energy/Engineering | Health/Medicine | Science/Technology | Asia & Pacific -
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