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Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data

Author

Listed:
  • Jessica Ochalek

    (Centre for Health Economics, University of York, UK.)

  • James Lomas

    (Centre for Health Economics, University of York, UK)

  • Karl Claxton

    (Centre for Health Economics, University of York, UK.)

Abstract

Low- and middle-income countries (LMICs) face difficult decisions about which health care interventions are worthwhile given existing constraints on health care expenditure. Decisions require some assessment of the health opportunity costs of proposed investments, i.e., a ‘supply side’ cost-effectiveness threshold (CET) that represents the likely health effects of changes in health care expenditure. This paper provides a framework for generating country-level CETs using existing published estimates of the mortality effect of health expenditure. Two different estimation strategies are used (Bokhari et al (2007) and Moreno-Serra and Smith (2015)) and, where possible, estimation is extended to include other measures of mortality, survival and disability outcomes, reflecting the demographic and other characteristics of each LMIC. The results suggest that CETs representing likely health opportunity costs tend to be below the lower bound suggested by WHO of 1x GDP per capita. Hence, many previous and existing recommendations about which interventions are cost-effective that are based on the WHO threshold are likely to do more harm than good.

Suggested Citation

  • Jessica Ochalek & James Lomas & Karl Claxton, 2015. "Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data," Working Papers 122cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:122cherp
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    File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP122_cost_DALY_LMIC_threshold.pdf
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    References listed on IDEAS

    as
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    Cited by:

    1. Aidan Hollis, 2016. "Sustainable Financing of Innovative Therapies: A Review of Approaches," PharmacoEconomics, Springer, vol. 34(10), pages 971-980, October.
    2. repec:spr:aphecp:v:15:y:2017:i:3:d:10.1007_s40258-016-0304-8 is not listed on IDEAS
    3. Ryota Nakamura & James Lomas & Karl Claxton & Farasat Bokhari & Rodrigo Moreno Serra & Marc Suhrcke, 2016. "Assessing the impact of health care expenditures on mortality using cross-country data," Working Papers 128cherp, Centre for Health Economics, University of York.
    4. Jessica Ochalek & Karl Claxton & Paul Revill & Mark Sculpher & Alexandra Rollinger, 2016. "Supporting the development of an essential health package: principles and initial assessment for Malawi," Working Papers 136cherp, Centre for Health Economics, University of York.

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