Resources Repository
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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…
Cost-Effectiveness Analysis | Costing Methods | Global | Priority Setting/Ethics | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | Science/Technology -
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…
Cost-Effectiveness Analysis | Global | Preferences/Values | Priority Setting/Ethics | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2022Health and Financial Risk Protection Outcomes in Economic Evaluations
Extended cost-effectiveness analysis was developed to evaluate health interventions in terms of level and distribution …
Extended cost-effectiveness analysis was developed to evaluate health interventions in terms of level and distribution of health gains and financial risk protection. This information is typically presented in a joint display format. This article develops and applies an algebraic money-metric formulation that incorporates all disaggregated outcomes and finds that ranking of health interventions is sensitive to the decision maker’s aversion to inequality across income groups and that financial risk protection gains are most important to…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Chronic Disease/Risk | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Cost-Effectiveness Analysis | Costing Methods | Global | Evidence Synthesis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Cost-Effectiveness Analysis | Calibration/Validation | Global | Mathematical Models | Microsimulation | Decision Analysis | Infectious Diseases -
ArticlePublication 2020Impact of Treatment and Imaging Modalities on 5-Year Net Survival of 11 Cancers in 200 Countries
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 …
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 countries/territories for 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate). The paper estimated current 5-year net survival for diagnosed cancers in each country and potential survival gains from increasing the availability of individual treatment and imaging modalities, and more comprehensive packages of scale-up. Global 5-year net survival for all 11 cancers (combined) is…
Calibration/Validation | Global | Priority Setting/Ethics | Health Outcomes | Microsimulation | Chronic Disease/Risk | Health Systems -
ArticlePublication 2022Priority Setting in Early Childhood Development: An Analytical Framework
Early childhood development (ECD) sets the foundation for healthy and successful lives with important consequences …
Early childhood development (ECD) sets the foundation for healthy and successful lives with important consequences for education, labor market outcomes, and other domains of well-being. Even though many ECD interventions are implemented and evaluated globally, there is currently no standardized framework for comparing these interventions’ relative cost-effectiveness. The investigators developed an economic evaluation framework that focuses on the immediate impact of ECD interventions targeting motor, cognitive, language, and socioemotional skills. They applied the framework to compute…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Decision Analysis | Child/Nutrition -
ArticlePublication 2021Rational Policymaking during a Pandemic
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and …
Policymaking during a pandemic can be extremely challenging. As COVID-19 is a new disease and its global impacts are unprecedented, decisions are taken in a highly uncertain, complex, and rapidly changing environment. In such a context, in which human lives and the economy are at stake, the authors argue that using ideas and constructs from modern decision theory, even informally, will make policymaking a more responsible and transparent process.
Global | Decision Theory | Priority Setting/Ethics | Infectious Diseases | Policy/Regulation | Government/Law | Health/Medicine | Science/Technology