International Journal of Health Policy and Management

International Journal of Health Policy and Management

Methods for the Economic Evaluation of Health Care Interventions for Priority Setting in the Health System: An Update From WHO CHOICE

Document Type : Perspective

Authors
Melanie Y. Bertram
Jeremy A. Lauer
Karin Stenberg
Tessa Tan Torres Edejer
Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
10.34172/ijhpm.2020.244
Abstract
The World Health Organization’s (WHO’s) Choosing Interventions that are Cost-Effective (CHOICE) programme has been a global leader in the field of economic evaluation, specifically cost-effectiveness analysis for almost 20 years. WHO-CHOICE takes a “generalized” approach to cost-effectiveness analysis that can be seen as a quantitative assessment of current and future efficiency within a health system. This supports priority setting processes, ensuring that health stewards know how to spend resources in order to achieve the highest health gain as one consideration in strategic planning. This approach is unique in the global health landscape. This paper provides an overview of the methodological approach, updates to analytic framework over the past 10 years, and the added value of the WHO-CHOICE approach in supporting decision makers as they aim to use limited health resources to achieve the Sustainable Development Goals (SDGs) by 2030.
Keywords
Cost-Effectiveness Analysis
Economic Evaluation
Health Benefit Package

 

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  1. Hutubessy R, Chisholm D, Edejer TT. Generalized cost-effectiveness analysis for national-level priority-setting in the health sector. Cost Eff Resour Alloc. 2003;1(1):8. doi:10.1186/1478-7547-1-8
  2. Lauer JA, Rajan D, Bertram MY. Priority setting for universal health coverage: we need to focus both on substance and on process: comment on "priority setting for universal health coverage: we need evidence-informed deliberative processes, not just more evidence on cost-effectiveness." Int J Health Policy Manag. 2017;6(10):601-603. doi:10.15171/ijhpm.2017.06
  3. Griffiths EA, Hendrich JK, Stoddart SD, Walsh SC. Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold. Clinicoecon Outcomes Res. 2015;7:463-476. doi:10.2147/ceor.s87462
  4. Evans DB, Edejer TT, Adam T, Lim SS. Methods to assess the costs and health effects of interventions for improving health in developing countries. BMJ. 2005;331(7525):1137-1140. doi:10.1136/bmj.331.7525.1137
  5. Lauer JA, Röhrich K, Wirth H, Charette C, Gribble S, Murray CJ. PopMod: a longitudinal population model with two interacting disease states. Cost Eff Resour Alloc. 2003;1(1):6. doi:10.1186/1478-7547-1-6
  6. Salomon JA, Vos T, Hogan DR, et al. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2129-2143. doi:10.1016/s0140-6736(12)61680-8
  7. United Nations Population Division. World Population Prospects, the 2015 revision. Available from: http://esa.un.org/unpd/wpp/. Published July 2015.
  8. Drummond M, Sculpher M, Torrance G, O'Brien B, Stoddart G. Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press; 2005.
  9. Johns B, Baltussen R, Hutubessy R. Programme costs in the economic evaluation of health interventions. Cost Eff Resour Alloc. 2003;1(1):1. doi:10.1186/1478-7547-1-1
  10. Bertram MY, Stenberg K, Brindley C, et al. Disease control programme support costs: an update of WHO-CHOICE methodology, price databases and quantity assumptions. Cost Eff Resour Alloc. 2017;15:21. doi:10.1186/s12962-017-0083-6
  11. Jit M, Mibei W. Discounting in the evaluation of the cost-effectiveness of a vaccination programme: a critical review. Vaccine. 2015;33(32):3788-3794. doi:10.1016/j.vaccine.2015.06.084
  12. Claxton K, Paulden M, Gravelle H, Brouwer W, Culyer AJ. Discounting and decision making in the economic evaluation of health-care technologies. Health Econ. 2011;20(1):2-15. doi:10.1002/hec.1612
  13. Giving What We Can, Techcnical Working Paper. https://assets.ctfassets.net/dhpcfh1bs3p6/7t4MgiycIceN88BEAeu31E/fdafd35a540bf319bb4a1a483c42fb73/Discount.pdf.
  14. Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-2223. doi:10.1016/s0140-6736(12)61689-4
  15. Neumann PJ, Anderson JE, Panzer AD, et al. Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures. Gates Open Res. 2018;2:5. doi:10.12688/gatesopenres.12786.2
  16. Marseille E, Larson B, Kazi DS, Kahn JG, Rosen S. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ. 2015;93(2):118-124. doi:10.2471/blt.14.138206
  17. WHO Commission on Macroeconomics and Health. Report of the WHO Commission on Macroeconomics and Health. Geneva: World Health Organization; 2002:4.
  18. Bertram MY, Lauer JA, De Joncheere K, et al. Cost-effectiveness thresholds: pros and cons. Bull World Health Organ. 2016;94(12):925-930. doi:10.2471/blt.15.164418
  19. Williams I, Bryan S. Lonely at the top and stuck in the middle? the ongoing challenge of using cost-effectiveness information in priority setting: comment on "use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden." Int J Health Policy Manag. 2015;4(3):185-187. doi:10.15171/ijhpm.2015.32

  • Received Date 21 December 2019
  • Revised Date 17 November 2020
  • Accepted Date 28 November 2020
  • First Published Date 20 January 2021
  • Published Date 01 November 2021