Resources Repository
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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;…
Priority Setting/Ethics | Government/Law | Education/Labor | Economics/Finance | Sub-Saharan Africa | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Economics/Finance | Sub-Saharan Africa | Preferences/Values | Cost-Effectiveness Analysis | Infectious Diseases | Health/Medicine -
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 | Economics/Finance | Europe | Sub-Saharan Africa | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Priority Setting/Ethics | Education/Labor | Economics/Finance | Sub-Saharan Africa | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Social Determinants | Health Systems | Health/Medicine | 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…
Priority Setting/Ethics | Government/Law | Climate/Environment | Europe | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine | Science/Technology | Global -
ArticlePublication 2015Extended Cost-Effectiveness Analysis of Treatment and Prevention of Diarrhoea in Ethiopia
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits …
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits due to the treatment and prevention of diarrhoea (i.e., rotavirus vaccination) in Ethiopia. The authors use an economic model to examine the impacts of universal public finance (UPF) of diarrhoeal treatment alone, as opposed to diarrhoeal treatment along with rotavirus vaccination using extended cost-effectiveness analysis (ECEA). The study finds that diarrhoeal treatment paired with rotavirus vaccination is more cost effective…
Priority Setting/Ethics | Climate/Environment | Economics/Finance | Sub-Saharan Africa | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Environmental Health | Health Systems | Health/Medicine -
ArticlePublication 2022Equity Impact of Minimum Unit Pricing of Alcohol
South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) …
South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa. Authors estimate MUP would reduce consumption more among the poorest than the richest drinkers. A MUP policy in South Africa has…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Chronic Disease/Risk | Social Determinants | Policy/Regulation | Health/Medicine -
ArticlePublication 2017Catastrophic Costs Potentially Averted by TB Control in India and South Africa
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis …
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis services in India and South Africa from 2016 to 2035, in line with the End TB Strategy. The authors investigated three intervention scenarios: improved treatment of drug-sensitive tuberculosis; improved treatment of multidrug-resistant tuberculosis; and expansion of access to tuberculosis care through intensified case finding (South Africa only). In India and South Africa, improvements in treatment for drug-sensitive and multidrug-resistant tuberculosis…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Mathematical Models | Infectious Diseases | Health Systems | Health/Medicine | Asia & Pacific -
ArticlePublication 2018Equity Impact Vaccines May Have on Averting Deaths and Medical Impoverishment
In this analysis, authors estimated the number of deaths averted and the number of cases …
In this analysis, authors estimated the number of deaths averted and the number of cases of medical impoverishment averted of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. The study found that vaccines administered between 2016 and 2030 would prevent 36 million deaths. Vaccines will have the greatest impact on reducing cases of poverty caused by hepatitis B, helping an estimated 14 million people avoid medical impoverishment. An…
Priority Setting/Ethics | Economics/Finance | Sub-Saharan Africa | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Global Governance | Health/Medicine | Science/Technology | Middle East & North Africa | Asia & Pacific