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 | Cost-Effectiveness Analysis | Government/Law | Asia & Pacific | Sub-Saharan Africa | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Health/Medicine | Middle East & North Africa | Latin America & Caribbean -
ArticlePublication 2016An Economic Evaluation of the PEN Program in Indonesia
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) …
Responding to the economic and health burden of noncommunicable diseases (NCDs), the World Health Organization (WHO) introduced the Package of Essential Noncommunicable disease (PEN) interventions. Several countries, including Indonesia, implemented the PEN program. To assess the value of the investment in the current program, an economic evaluation of the program was conducted with collaboration between the Ministry of Health in Indonesia, the WHO, and the International Decision Support Initiative (iDSI). This study evaluated the delivery of…
Priority Setting/Ethics | Technology Assessment | Cost-Effectiveness Analysis | Government/Law | Asia & Pacific | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine -
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 | Cost-Effectiveness Analysis | Government/Law | Global | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology -
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 | Cost-Effectiveness Analysis | Government/Law | Global | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | 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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Government/Law | Global | Health Systems | Culture/Society | Economics/Finance | Health/Medicine -
ArticlePublication 2024Adopting Electric School Buses in the U.S.: Health & Climate Benefits
This article evaluates the health and climate benefits of replacing diesel school buses with electric …
This article evaluates the health and climate benefits of replacing diesel school buses with electric models in the U.S. Despite the high cost of electric buses, their benefits in reducing mortality and childhood asthma, as well as greenhouse gas emissions, could justify the investment. The study quantifies the benefits of replacing an average diesel bus with an electric bus, estimating $84,200 in total benefits per bus, with $40,400 from climate benefits and $43,800 from health…
Benefit-Cost Analysis | Government/Law | North America | Environmental Health | Health/Medicine -
ArticlePublication 2023Benefits and Costs of COVID-19 Vaccine Mandates
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations …
Written mid-pandemic, this article evaluates the direct costs and health benefits of requiring COVID-19 vaccinations for U.S. federal employees and healthcare and private sector workers. These mandates were controversial and some were halted by litigation. If they had been implemented as intended, the net benefits would depend on the course of the pandemic. If a more transmissible variant (such as Omicron) emerges, the net benefits may be large. If the pandemic instead fades, the benefits…
Benefit-Cost Analysis | Government/Law | North America | Mathematical Models | State-Transition | Infectious Diseases | Policy/Regulation | Business/Industry | Economics/Finance | Health/Medicine -
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.
Priority Setting/Ethics | Government/Law | Global | Decision Theory | Infectious Diseases | Policy/Regulation | Health/Medicine | Science/Technology -
ArticlePublication 2020Valuing COVID-19 Mortality Risk
In this article, the author evaluates whether conventional estimates of the value per statistical life …
In this article, the author evaluates whether conventional estimates of the value per statistical life (VSL) in the United States (about $10 million) are appropriate for evaluating policies that affect risk of COVID-19. This estimate may be too large, because: (1) VSL estimates marginal values but COVID-19 risks can be non-marginal; (2) VSL is estimated for the average resident, but COVID-19 mortality is concentrated among the elderly; and (3) the pandemic has caused substantial losses…
Benefit-Cost Analysis | Government/Law | Global | Preferences/Values | Infectious Diseases