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‘Get three for the price of one’: evaluating the cost-effectiveness of multi-outcome interventions

Author

Listed:
  • Hernando Grueso
  • Chris Desmond
  • William E. Rudgard
  • Sopuruchukwu Obiesie
  • Lucie Cluver

Abstract

Cost-Effectiveness Analysis (CEA) is widely used among policymakers due to its intuitive way of estimating the cost of an intervention per unit of outcome improvement. For interventions with multiple outcomes, however, this standard approach tends to underestimate programme efficiency. We propose a method to discount cost-effectiveness ratios (CER) based on multiple benefits and illustrate it using RCT findings from a violence-reduction programme in Liberia. The standard CER suggests a cost of $51.8 to improve economic performance by 0.1 SD among cash-transfer recipients, but our discounting approach reduces this to $5 once two additional outcomes are considered. Although these figures reflect only private benefits without considering positive externalities for society at large, accounting for multiple outcomes helps identify cross-sector synergies and compare the efficiency of interventions achieving similar results.

Suggested Citation

  • Hernando Grueso & Chris Desmond & William E. Rudgard & Sopuruchukwu Obiesie & Lucie Cluver, 2026. "‘Get three for the price of one’: evaluating the cost-effectiveness of multi-outcome interventions," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 18(1), pages 47-62, January.
    • Handle: RePEc:taf:jdevef:v:18:y:2026:i:1:p:47-62
    DOI: 10.1080/19439342.2025.2591638
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