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 | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | 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 | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
ArticlePublication 2016Challenges of Prioritization
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and …
Cost-effectiveness analysis has traditionally been applied primarily to very specific interventions, such as drugs and diagnostics; in addition, the evidence base drawn on for evaluating such interventions is relatively good, given the medical research industry surrounding their testing. However, with increasing success in controlling infectious diseases, many of the health challenges facing countries concern broad threats to health with multiple causes, such as obesity, where the relationship between policy action and health benefit is not…
Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Priority Setting/Ethics | Evidence Synthesis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2016Universal Health Coverage as a Pathway to the Sustainable Development Goals
The inclusion of universal health coverage (UHC) as a target in the health Sustainable Development …
The inclusion of universal health coverage (UHC) as a target in the health Sustainable Development Goals speaks to its importance as both a foundational and an end goal for global health. Across the globe, countries are in varying stages of progress toward UHC. To help countries where there is a wide gap between the reality of limited access and the aspirations of universality, the author argues that there must be prioritized investments to progressively realize…
Priority Setting/Ethics | Social Determinants | Health Systems | Global Governance | Health/Medicine | Global -
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 | Technology Assessment | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | 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 | Health Systems | Culture/Society | Economics/Finance | Government/Law | Health/Medicine | Global -
Tutorial/PrimerPublication, Teaching Resource 2016Distributional Cost-Effectiveness Analysis: A Tutorial
This tutorial explains distributional cost-effectiveness analysis as a framework for incorporating health inequality concerns into …
This tutorial explains distributional cost-effectiveness analysis as a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. Using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme the authors describe the technical details of how to conduct distributional cost-effectiveness analysis. The 2 key stages are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Europe -
ArticlePublication 2016Extended CEA: Diarrhea and Pneumonia in Ethiopia
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea …
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea in Ethiopia, with a focus on children under age five years. This extended cost-effectiveness analysis examines benefits by income quintile so that policy makers can better understand how each package affects different segments of the population and permits the incorporation of financial risk protection in the economic evaluation of health policies - both critical elements of universal health coverage.
Priority Setting/Ethics | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa