Several guidelines on cost-effectiveness analysis (CEA) already exist. There are two reasons for producing another set. The first is that traditional or, incremental, CEA ignores the question of whether, the current mix of interventions represents an efficient use of resources. Secondly,the resources required to evaluate the large number of interventions required to use CEA to identify opportunities to enhance efficiency are prohibitive. The approach of Generalized CEA proposed in this Guide seeks to provide analysts with a method of assessing whether the current as well as proposed mix of interventions is efficient. It also seeks to maximize the generalizability of results across settings. The Guide, in Part I, begins with a brief description of Generalized CEA and how it relates to the two questions raised above. It then considers issues relating to study design, estimating costs, assessing health effects, discounting, uncertainty and sensitivity analysis, and reporting results. Detailed discussions of selected technical issues, and applications are provided in a series of, background papers, originally published in journals, but included in this book for easy reference in Part II. The Guide and these papers, are written in the context of the work of WHO-CHOICE: CHOosing Interventions that are Cost-Effective. WHO-CHOICE is assembling regional databases on the costs, impact on population health and cost-effectiveness of, key health interventions using standardized methodology and tools. WHO-CHOICE tools on costing (CostIt©), population effectiveness modelling (PopMod©) and probabilistic uncertainty analysis (MCLeague©) are included in the accompanying compact disc.
Author(s): R. Baltussen, T. Adams, T. Tan Torres, R. Hutubessy, A. Acharya, D.B. Evans, C.J.L. Murray
Publisher: World Health Organization
Year: 2003
Language: English
Pages: 330
Contents......Page 6
Preface......Page 10
List of Acronyms and Abbreviations......Page 19
PART ONE: METHODS FOR GENERALIZED COST-EFFECTIVENESS ANALYSIS......Page 21
1. What is Generalized Cost-Effectiveness Analysis?......Page 22
2. Undertaking a study using GCEA......Page 35
3. Estimating costs......Page 46
4. Estimating health effects......Page 66
5. Discounting......Page 84
6. Uncertainty in cost-effectiveness analysis......Page 89
7. Policy uses of Generalized CEA......Page 99
8. Reporting CEA results......Page 107
9. Summary of recommendations......Page 109
References......Page 112
Annex A. WHO-CHOICE activities on Generalized Cost-Effectiveness Analysis......Page 122
Annex B. Draft list of intervention clusters for evaluation by WHO-CHOICE......Page 125
Annex C. An illustration of the types of costs included in a selection of intervention activities at central levels......Page 126
Annex D. Interpreting international dollars......Page 127
Annex E. DALYs to measure burden of disease......Page 128
Annex F. Measuring intervention benefit at the population level......Page 130
Annex G. Epidemiological subregions as applied in WHO Generalized CEA......Page 133
Endnotes......Page 134
PART TWO: BACKGROUND PAPERS AND APPLICATIONS......Page 138
1. Development of WHO guidelines on generalized cost-effectiveness analysis......Page 139
2. PopMod: A longitudinal population model with two interacting disease states......Page 165
3. Programme costs in the economic evaluation of health interventions......Page 191
4. Econometric estimation of country-specific hospital costs......Page 210
5. Stochastic league tables: communicating cost-effectiveness results to decision-makers......Page 230
6. Uncertainty in cost-effectiveness analysis: probabilistic uncertainty analysis and stochastic league tables......Page 238
7. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk......Page 250
8. Generalized cost-effectiveness analysis: an aid to decision making in health......Page 289
9. Ethical issues in the use of cost effectiveness analysis for the prioritization of health care resources......Page 301
C......Page 325
G......Page 327
N......Page 328
S......Page 329
W......Page 330
