Resources Repository
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ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Cost-Effectiveness Analysis | Priority Setting/Ethics | Benefit-Cost Analysis | Technology Assessment | Health Systems | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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 | Costing Methods | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Global -
BookPublication 2016Cost-Effectiveness Analysis in Health: A Practical Approach, 3rd Edition
Cost-Effectiveness Analysis in Health provides an introduction to the tools, methods, and procedures used to perform cost-effectiveness research. …
Cost-Effectiveness Analysis in Health provides an introduction to the tools, methods, and procedures used to perform cost-effectiveness research. This third edition contains new discussion on meta-analysis and advanced modeling techniques, a worked example using visual modeling software TreeAge Pro, and updated recommendations from the U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. The book provides process-specific instruction in a concise, structured format to highlight common methods and techniques for: 1) Developing a thoroughly fleshed-out research project; 2) Working…
Cost-Effectiveness Analysis | Preferences/Values | Costing Methods | Health Outcomes | Evidence Synthesis | Technology Assessment | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | North America -
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 | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Priority Setting/Ethics | Benefit-Cost 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…
Cost-Effectiveness Analysis | Priority Setting/Ethics | Evidence Synthesis | Policy/Regulation | 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…
Cost-Effectiveness Analysis | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Priority Setting/Ethics | Health Systems | Culture/Society | Economics/Finance | Government/Law | Health/Medicine | Global