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 | Education/Labor | Health Systems | Policy/Regulation | 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 | Cost-Effectiveness Analysis | Government/Law | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Global -
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 | Cost-Effectiveness Analysis | Education/Labor | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa | 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 | Cost-Effectiveness Analysis | Government/Law | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Health/Medicine | Science/Technology | Global | Europe -
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 | Cost-Effectiveness Analysis | Government/Law | Technology Assessment | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Asia & Pacific -
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 | Health Systems | Culture/Society | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2015Broader Economic Impact of Vaccination: Reviewing and Appraising the Strength of Evidence
Economic evaluations of public health programs such as immunization often consider only direct health benefits and …
Economic evaluations of public health programs such as immunization often consider only direct health benefits and medical cost savings. Evidence linking immunization to important benefits in indicators such as childhood development, household behavior, and other macro-economic data are unclear. A conceptual framework of the pathways between immunization and these broader economic benefits was developed through expert consultation. The authors obtained articles from previous reviews, snowballing, and expert consultation, and associated them with one of the pathways and assessed them using modified Grading…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Education/Labor | Preferences/Values | Costing Methods | Evidence Synthesis | Benefit-Cost Analysis | Infectious Diseases | Social Determinants | 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 | Decision Theory | Infectious Diseases | Policy/Regulation | Health/Medicine | Science/Technology | Global -
ArticlePublication 2013Nutritional Policy Changes in SNAP: A Microsimulation and Cost-Effectiveness Analysis
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) …
This analysis estimated the health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) or subsidizing fruits and vegetables purchased with SNAP. The target population was adults in the U.S. and the time horizon was 10 years. Results showed that banning SSB purchases using SNAP benefits would be expected to avert 510,000 diabetes person-years and 52,000 deaths from MIs and strokes over the next decade, with a savings of $2900 per QALY saved. A…
Cost-Effectiveness Analysis | Government/Law | Mathematical Models | Microsimulation | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Food/Agriculture | Health/Medicine | North America