Resources Repository
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ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Cost-Effectiveness Analysis | Global | Costing Methods | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine -
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;…
Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | 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…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | 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…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Benefit-Cost Analysis | Infectious Diseases | Chronic Disease/Risk | Mental Health | Health Systems | Economics/Finance | Health/Medicine -
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…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Evidence Synthesis | Policy/Regulation | Health/Medicine -
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…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Health Systems | Culture/Society | Economics/Finance | Government/Law | Health/Medicine -
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.
Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Health Outcomes | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Economics/Finance | Health/Medicine -
ReviewPublication 2016Review: CEA for Maternal, Newborn, Child Health
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions …
This chapter summarizes the findings of a systematic search of the cost-effectiveness literature on interventions to improve reproductive, maternal, newborn, and child health. Interventions for newborn health, treatment of febrile illness, immunization against preventable diseases, and micronutrient interventions remain among the most cost-effective and affordable. Other studies explore how to provide existing interventions using new platforms to increase outreach or decrease cost per person covered, or both. Interventions provided in the community may achieve both purposes to…
Cost-Effectiveness Analysis | Global | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Education/Labor | Health/Medicine -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Economics/Finance | Health/Medicine