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Development of WHO guidelines on generalized cost‐effectiveness analysis

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  • Christopher J.L. Murray
  • David B. Evans
  • Arnab Acharya
  • Rob M.P.M. Baltussen

Abstract

The growing use of cost‐effectiveness analysis (CEA) to evaluate specific interventions is dominated by studies of prospective new interventions compared with current practice. This type of analysis does not explicitly take a sectoral perspective in which the costs and effectiveness of all possible interventions are compared, in order to select the mix that maximizes health for a given set of resource constraints. WHO guidelines on generalized CEA propose the application of CEA to a wide range of interventions to provide general information on the relative costs and health benefits of different interventions in the absence of various highly local decision constraints. This general approach will contribute to judgements on whether interventions are highly cost‐effective, highly cost‐ineffective, or something in between. Generalized CEAs require the evaluation of a set of interventions with respect to the counterfactual of the null set of the related interventions, i.e. the natural history of disease. Such general perceptions of relative cost‐effectiveness, which do not pertain to any specific decision‐maker, can be a useful reference point for evaluating the directions for enhancing allocative efficiency in a variety of settings. The proposed framework allows the identification of current allocative inefficiencies as well as opportunities presented by new interventions. Copyright © 1999 John Wiley & Sons, Ltd.

Suggested Citation

  • Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
  • Handle: RePEc:wly:hlthec:v:9:y:2000:i:3:p:235-251
    DOI: 10.1002/(SICI)1099-1050(200004)9:3<235::AID-HEC502>3.0.CO;2-O
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    File URL: https://doi.org/10.1002/(SICI)1099-1050(200004)9:33.0.CO;2-O
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    References listed on IDEAS

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    Cited by:

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    3. Raymond C. W. Hutubessy & Louis W. Niessen & Rob F. Dijkstra & Ton F. Casparie & Frans F. Rutten, 2005. "Stochastic league tables: an application to diabetes interventions in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 445-455, May.
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    5. Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    6. Milton C. Weinstein, 2012. "Decision Rules for Incremental Cost-effectiveness Analysis," Chapters, in: Andrew M. Jones (ed.),The Elgar Companion to Health Economics, Second Edition, chapter 47, Edward Elgar Publishing.
    7. Kapiriri, Lydia & Razavi, Donya, 2017. "How have systematic priority setting approaches influenced policy making? A synthesis of the current literature," Health Policy, Elsevier, vol. 121(9), pages 937-946.
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    9. Mei-Chuan Hung & Hsin-Ming Lu & Likwang Chen & Ming-Shian Lin & Cheng-Ren Chen & Chong-Jen Yu & Jung-Der Wang, 2012. "Cost per QALY (Quality-Adjusted Life Year) and Lifetime Cost of Prolonged Mechanical Ventilation in Taiwan," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-10, September.
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    11. Shepherd, Keith D. & Shepherd, Gemma & Walsh, Markus G., 2015. "Land health surveillance and response: A framework for evidence-informed land management," Agricultural Systems, Elsevier, vol. 132(C), pages 93-106.
    12. Bin Wu & Baijun Dong & Yuejuan Xu & Qiang Zhang & Jinfang Shen & Huafeng Chen & Wei Xue, 2012. "Economic Evaluation of First-Line Treatments for Metastatic Renal Cell Carcinoma: A Cost-Effectiveness Analysis in A Health Resource–Limited Setting," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-13, March.
    13. Nuti, Sabina & Vainieri, Milena & Bonini, Anna, 2010. "Disinvestment for re-allocation: A process to identify priorities in healthcare," Health Policy, Elsevier, vol. 95(2-3), pages 137-143, May.
    14. Lai, Taavi & Habicht, Jarno & Reinap, Marge & Chisholm, Dan & Baltussen, Rob, 2007. "Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia," Health Policy, Elsevier, vol. 84(1), pages 75-88, November.
    15. Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
    16. Stephen Resch & Eline Korenromp & John Stover & Matthew Blakley & Carleigh Krubiner & Kira Thorien & Robert Hecht & Rifat Atun, 2011. "Economic Returns to Investment in AIDS Treatment in Low and Middle Income Countries," PLOS ONE, Public Library of Science, vol. 6(10), pages 1-9, October.
    17. Samia Laokri & Maxime Koiné Drabo & Olivier Weil & Benoît Kafando & Sary Mathurin Dembélé & Bruno Dujardin, 2013. "Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-6, February.
    18. Ezzati, Majid & Kammen, Daniel M., 2002. "Evaluating the health benefits of transitions in household energy technologies in Kenya," Energy Policy, Elsevier, vol. 30(10), pages 815-826, August.
    19. Llanos, Adolfo & Hertrampf, Eva & Cortes, Fanny & Pardo, Andrea & Grosse, Scott D. & Uauy, Ricardo, 2007. "Cost-effectiveness of a folic acid fortification program in Chile," Health Policy, Elsevier, vol. 83(2-3), pages 295-303, October.
    20. David B. Evans & Dan Chisholm & Tessa Tan-Torres Edejer, 2012. "Generalized Cost-effectiveness Analysis: Principles and Practice," Chapters, in: Andrew M. Jones (ed.),The Elgar Companion to Health Economics, Second Edition, chapter 48, Edward Elgar Publishing.
    21. Baltussen, Rob & Youngkong, Sitapon & Paolucci, Francesco & Niessen, Louis, 2010. "Multi-criteria decision analysis to prioritize health interventions: Capitalizing on first experiences," Health Policy, Elsevier, vol. 96(3), pages 262-264, August.
    22. Gonzalo M Vazquez-Prokopec & Cynthia Spillmann & Mario Zaidenberg & Uriel Kitron & Ricardo E Gürtler, 2009. "Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(1), pages 1-11, January.
    23. Robberstad, Bjarne & Norheim, Ole F., 2011. "Incorporating concerns for equal lifetime health in evaluations of public health programs," Social Science & Medicine, Elsevier, vol. 72(10), pages 1711-1716, May.
    24. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    25. Hyder, Adnan A. & Aggarwal, Anju, 2009. "The increasing burden of injuries in Eastern Europe and Eurasia: Making the case for safety investments," Health Policy, Elsevier, vol. 89(1), pages 1-13, January.

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