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ArticlePublication 2022Child Health Inequity through Case Management of Under-Five Malaria in Nigeria: An ECEA
This study assesses the potential impact of subsidies covering the direct and indirect costs of …
This study assesses the potential impact of subsidies covering the direct and indirect costs of under-five malaria case management in Nigeria, utilizing an extended cost-effectiveness analysis (ECEA) and a decision tree model. Findings reveal that fully subsidizing medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8,600 cases of catastrophic health expenditure (CHE), and US$187 million in out-of-pocket (OOP) spending. Per US$1 million invested, this translates to a significant reduction in under-five…
Cost-Effectiveness Analysis | Child/Nutrition | Health Outcomes | Mathematical Models | Infectious Diseases | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2020Equity & Distributional Impact on Stunting of a Nutritional Package, Children Aged 6-36 Months in China: Modeling Study Findings
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional …
This article evaluates the potential impact of rolling out the Ying Yang Bao (YYB) nutritional package on child stunting across provinces and wealth groups in China, focusing on equity. Utilizing data from the China Family Panel Studies and extended cost-effectiveness analysis methods, the study estimates the distributional impact of a 12-month YYB program for children aged 6-36 months across 25 provinces and two wealth groups. Results indicate that a 75% coverage of YYB could avert…
Cost-Effectiveness Analysis | Child/Nutrition | Health Outcomes | Mathematical Models | Health/Medicine | Asia & Pacific -
ArticlePublication 2020Health Gains & Financial Risk Protection Afforded by Public Financing of Selected Malaria Interventions in Ethiopia: An ECEA
This article, published in the Malaria Journal, aims to estimate the expected health and financial …
This article, published in the Malaria Journal, aims to estimate the expected health and financial risk protection (FRP) benefits of universal public financing of key malaria interventions in Ethiopia. An extended cost-effectiveness analysis (ECEA) is used to estimate the potential health and FRP benefits of publicly financing a 10% increase in artemisinin-based combination therapy (ACT), long-lasting insecticide-treated bed nets (LLIN), indoor residual spraying (IRS), and a hypothetical malaria vaccine. The results indicate that ACT, LLIN,…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Infectious Diseases | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2020Who Benefits Most from Extending Financial Protection for Cataract Surgery in Vietnam?: An ECEA
This study evaluated the potential impact, on health and financial protection, of eliminating medical and …
This study evaluated the potential impact, on health and financial protection, of eliminating medical and non-medical out-of-pocket costs associated with cataract surgery in Vietnam using extended cost-effectiveness analysis.
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Chronic Disease/Risk | Health Systems | Health/Medicine | Asia & Pacific -
ArticlePublication 2019Health & Financial Benefits of Tobacco Taxes in Colombia: Results from a Modelling Study
Using extended cost-effectiveness analysis methods, the authors assessed the distributional impact across socioeconomic groups of …
Using extended cost-effectiveness analysis methods, the authors assessed the distributional impact across socioeconomic groups of a tax on tobacco on selected health and financial outcomes in Colombia. They estimated over a 20 year time period the years of life gained with smoking cessation and the increased tax revenues, associated with a 70% relative price increase of the pack of cigarettes. The authors predict that over 20 years, the tax increase would lead to over 190,000…
Cost-Effectiveness Analysis | Social Determinants | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2019Impact of a Tax on Sweetened Beverages in the Philippines: an ECEA
This study used extended cost-effectiveness analyses to estimate the effect of the sweetened beverages tax …
This study used extended cost-effectiveness analyses to estimate the effect of the sweetened beverages tax in the Philippines on the numbers of premature deaths averted attributed to type 2 diabetes mellitus, ischemic heart disease and stroke, across income quintiles over the period 2018-2037. The study also estimated the financial benefits of the tax from reductions in out-of-pocket payments, direct medical costs averted, and government health-care cost savings. The analysis showed that the tax could avert…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Asia & Pacific -
ArticlePublication 2019Impact of Taxing Sugar-Sweetened Beverages in South Africa: An ECEA
In this paper, the authors conducted an extended cost-effectiveness analysis of a newly imposed tax …
In this paper, the authors conducted an extended cost-effectiveness analysis of a newly imposed tax on sugar-sweetened beverages (SSBs) in South Africa. They estimated the averted premature deaths related to type 2 diabetes mellitus (T2DM), financial benefits to households, increased government tax revenues, and healthcare savings for the government, across various income quintiles. The authors found that a 10% SSB tax increase would avert an estimated 8,000 T2DM-related premature deaths over 20 years, with most…
Cost-Effectiveness Analysis | Social Determinants | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2018Applications of ECEA Methodology in DCP3
Extended cost-effectiveness analyses (ECEAs) build on cost-effectiveness analyses (CEAs) by assessing consequences in both the …
Extended cost-effectiveness analyses (ECEAs) build on cost-effectiveness analyses (CEAs) by assessing consequences in both the health and non-health domains. The ECEA approach proves novel in that it includes equity and non-health benefits (FRP) in the economic evaluation of health policies, which enables multiple criteria to factor in the decision-making process. More important, the ECEA approach enables the design of benefits packages, such as essential universal health care and the highest-priority package, based on the quantitative…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Health Systems | Global Governance | Health/Medicine | Global -
ArticlePublication 2018Consequences of a Cigarette Price Increase in 13 Middle Income Countries
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in …
This study used extended cost-effectiveness analysis to examine the impact of a 50% increase in market prices of cigarettes on health, poverty, and financial protection for men in 13 middle income countries. A 50% increase in cigarette prices would lead to about 450 million years of life gained across the 13 countries from smoking cessation, with half of these in China. Across all countries, men in the bottom income group would gain 6.7 times more…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Global -
ArticlePublication 2018Equity Impact Vaccines May Have on Averting Deaths and Medical Impoverishment
In this analysis, authors estimated the number of deaths averted and the number of cases …
In this analysis, authors estimated the number of deaths averted and the number of cases of medical impoverishment averted of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. The study found that vaccines administered between 2016 and 2030 would prevent 36 million deaths. Vaccines will have the greatest impact on reducing cases of poverty caused by hepatitis B, helping an estimated 14 million people avoid medical impoverishment. An…
Cost-Effectiveness Analysis | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Infectious Diseases | Global Governance | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2018Modeling Gains from Investing in Preventive Chemotherapy for NTDs in Madagascar
In this paper, the authors conducted an extended cost-effectiveness analysis (ECEA) to five Neglected Tropical …
In this paper, the authors conducted an extended cost-effectiveness analysis (ECEA) to five Neglected Tropical Disease (NTD) interventions in Madagascar. The five NTDs included schistosomiasis, lymphatic filariasis, and three-soil transmitted helminthiases. The analysis found that preventive chemotherapy for all NTDs resulted $125 per DALY averted with a benefit-cost ratio between 5 and 31. Preventive chemotherapy for schistosomiasis alone was found to prevent over 175,000 infections, avert 2,000 DALYs and for every $100,000 spent, provide an additional…
Cost-Effectiveness Analysis | Social Determinants | Infectious Diseases | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2018Poverty Reduction & Equity Benefits of Measles, Rotavirus and Pneumococcal Vaccines in LMICs
This study uses the extended cost effectiveness analysis (ECEA) to evaluate the impact of immunization …
This study uses the extended cost effectiveness analysis (ECEA) to evaluate the impact of immunization against measles, severe pneumococcal disease and severe rotavirus for birth cohorts vaccinated over 2016–2030 for three scenarios in 41 Gavi-eligible countries: no immunization, current immunization coverage forecasts and the current immunization coverage enhanced with funding support. Following the distribution of the cases by socioeconomic group, the study found that the number of catastrophic health costs (CHC) cases attributable to measles,…
Cost-Effectiveness Analysis | Child/Nutrition | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Health/Medicine | Global -
ArticlePublication 2017Adolescent Pregnancy Prevention Program in Zambia
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an …
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. The study will be conducted alongside a cluster-randomized controlled trial, which tests the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Maternal/Reproductive Health | Health Systems | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Distributional Benefits of Tobacco Tax and Smoke-Free Workplaces in China
This study used the extended cost–effectiveness analysis (ECEA) to evaluate, across income quintiles of the …
This study used the extended cost–effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population, the premature deaths averted, the change in tax revenues generated, and the financial risk protection procured, that would follow a 75% increase in cigarette prices through substantial increments in excise tax fully passed onto consumers, and a nationwide total implementation of workplace smoking bans. A 75% increase in cigarette prices would avert about 24 million premature deaths among…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Asia & Pacific -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Chronic Disease/Risk | Environmental Health | Policy/Regulation | Climate/Environment | Economics/Finance | Energy/Engineering | Science/Technology | Asia & Pacific -
ArticlePublication 2017Reduced Burden of Childhood Diarrheal Diseases through Increased Access to Water and Sanitation in India: Modeling Analysis
This analysis estimates the health and economic benefits of scaling up the coverage of piped …
This analysis estimates the health and economic benefits of scaling up the coverage of piped water and improved sanitation to a near-universal 95% level among Indian households. The authors used an agent-based microsimulation platform, IndiaSim, to model disease progression and individual healthcare-seeking behavior in India, and use ECEA to estimate health and economic outcomes over time. They found that scaling up access to piped water and improved sanitation could avert 43,352 diarrheal episodes and 68…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Health Outcomes | Microsimulation | Environmental Health | Economics/Finance | Energy/Engineering | Health/Medicine | Science/Technology | Asia & Pacific -
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 | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Health Outcomes | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2016Extended CEA: Home-Based Neonatal Care in Rural India
This chapter examines the health, economic benefits, and government costs associated with scaling up a …
This chapter examines the health, economic benefits, and government costs associated with scaling up a publicly financed home-based neonatal care package in rural India. This extended cost-effectiveness analysis considers two intervention scenarios against a baseline of no home-based neonatal care, both of which would utilize community health workers - one would provide coverage to approximately 7 out of 10 rural newborns, and the other would provide coverage to 9 out of 10 rural newborns.
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Health Systems | Economics/Finance | Health/Medicine | Asia & Pacific -
Tutorial/PrimerPublication, Teaching Resource 2016Extended Cost-Effectiveness Analysis for Health Policy Assessment: A Tutorial
This tutorial describes both the intent of extended cost-effectiveness analysis and its keys to allow …
This tutorial describes both the intent of extended cost-effectiveness analysis and its keys to allow easy implementation for health policy assessment. Extended cost-effectiveness analysis was developed to address health policy assessment, specifically to evaluate the health and financial consequences of public policies in four domains: (1) the health gains; (2) the financial risk protection benefits; (3) the total costs to the policy makers; and (4) the distributional benefits.
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | 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…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Health Systems | Economics/Finance | Education/Labor | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2016Rotavirus Vaccines Contribute Towards UHC in A Mixed Public–Private Healthcare System
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from …
This extended cost-effectiveness analysis (ECEA) evaluates the non-health benefits of rotavirus vaccination in Malaysia from the household’s perspective. The authors found that rotavirus vaccination reduces rotavirus episodes and expenditure substantially and provides financial risk protection to all income groups. Although the rich are paying more out of pocket than the poor by utilizing more expensive healthcare, the poor are paying more in proportion to household income. Poverty reduction benefits are concentrated amongst the poorest two…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Mental Health | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2015Benefits of Scaling a Home-Based Neonatal Care Package in Rural India
In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community …
In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. The authors estimate the disease and economic burden that could be averted by scaling up the HBNC in rural India using IndiaSim, an agent-based simulation model. Under one scenario, the existing community health worker network begins providing HBNC for rural households without access to home- or facility-based newborn care. In the second scenario, coverage of…
Cost-Effectiveness Analysis | Child/Nutrition | Costing Methods | Microsimulation | Health Systems | Culture/Society | Health/Medicine | Asia & Pacific -
ArticlePublication 2015Consequences of Tobacco Tax in Rich and Poor Smokers in China: An ECEA
This study used the extended cost-effectiveness analysis methods to estimate, across income quintiles of the …
This study used the extended cost-effectiveness analysis methods to estimate, across income quintiles of the male population, the health benefits (years of life gained), the additional tax revenues raised, the net financial consequences for households, and the financial risk protection provided to households, that would be caused by a 50% increase in tobacco price through excise tax fully passed onto tobacco consumers in China. The analysis showed that a 50% increase in tobacco price through…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Mathematical Models | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Asia & Pacific -
ArticlePublication 2015Extended Cost-Effectiveness Analysis of Treatment and Prevention of Diarrhoea in Ethiopia
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits …
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits due to the treatment and prevention of diarrhoea (i.e., rotavirus vaccination) in Ethiopia. The authors use an economic model to examine the impacts of universal public finance (UPF) of diarrhoeal treatment alone, as opposed to diarrhoeal treatment along with rotavirus vaccination using extended cost-effectiveness analysis (ECEA). The study finds that diarrhoeal treatment paired with rotavirus vaccination is more cost effective…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Health Outcomes | Infectious Diseases | Environmental Health | Health Systems | Climate/Environment | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Health and Social Protection Effects of Measles Vaccination in Ethiopia: Extended CEA
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different …
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different vaccine delivery strategies in Ethiopia: (1) routine immunization, (2) routine immunization with financial incentives, and (3) mass campaigns, known as supplemental immunization activities (SIAs), for measles vaccination. At higher costs, SIAs reached higher levels of vaccine coverage. Routine immunization paired with financial incentives was found to increase the demand among poorer households.
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Infectious Diseases | Health Systems | Global Governance | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Health Gains & Financial Risk Protection by Public Financing in Ethiopia: An ECEA
This article, published in the Lancet Global Health, aims to evaluate the health and financial …
This article, published in the Lancet Global Health, aims to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. The authors used an extended cost-effectiveness analysis (ECEA) to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine interventions that the Government of Ethiopia aims to make universally available. This approach incorporates financial…
Cost-Effectiveness Analysis | Child/Nutrition | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Pneumococcal Vaccination and Pneumonia Treatment in Ethiopia: Results from Extended CEA
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully …
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully publicly financed interventions in Ethiopia: pneumococcal vaccination for newborns and pneumonia treatment for under-five children. The authors apply ECEA methods and estimate the program impact on: (1) government program costs; (2) pneumonia and pneumococcal deaths averted; (3) household expenses related to pneumonia/pneumococcal disease treatment averted; (4) prevention of household medical impoverishment; and (5) distributional consequences across the wealth strata of…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Costing Methods | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Costing Methods | Health Outcomes | Infectious Diseases | Health Systems | Policy/Regulation | Clinical Care | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2013Agent-Based Simulation Modelling Approach to ECEA of Health Interventions
This study develops a dynamic agent-based simulation model, the Disease Control Priorities Simulation (DCPSim) model, …
This study develops a dynamic agent-based simulation model, the Disease Control Priorities Simulation (DCPSim) model, to estimate the health and economic benefits of health interventions and policies. Authors examined two different policies that can scale up the availability of drugs for secondary prevention of acute myocardial infarction (AMI) in India: a universal public provision (UPP) that provides a drug for free at public health facilities, and a universal public finance (UPF) that provides a drug…
Cost-Effectiveness Analysis | Social Determinants | Priority Setting/Ethics | Dynamic Simulation | Chronic Disease/Risk | Policy/Regulation | Health/Medicine | Asia & Pacific -
ArticlePublication 2013Public Finance of Rotavirus Vaccination in India and Ethiopia: Extended CEA
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. The authors measured program impact on: (1) averted rotavirus deaths; (2) reduction in household expenditures; (3) financial risk protection; and (4) distributional consequences across the country’s wealth strata. In India and Ethiopia, the program was predicted to decrease rotavirus deaths substantially, and effectively provide financial risk protection among the poor, while also reducing household…
Cost-Effectiveness Analysis | Social Determinants | Child/Nutrition | Priority Setting/Ethics | Health Outcomes | Infectious Diseases | Culture/Society | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Asia & Pacific
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