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World Health Organization : Year 1999 ; Assessment Document, A68868: Development of World Health Organization Guidelines on Generalised Cost-Effectiveness Analysis

By David B. Evans

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Book Id: WPLBN0000158842
Format Type: PDF eBook
File Size: 0.2 MB
Reproduction Date: 2005
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Title: World Health Organization : Year 1999 ; Assessment Document, A68868: Development of World Health Organization Guidelines on Generalised Cost-Effectiveness Analysis  
Author: David B. Evans
Language: English
Subject: Health., Public health, Wellness programs
Collections: Medical Library Collection, World Health Collection
Publication Date:
Publisher: World Health Organization


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Evans, D. B. (n.d.). World Health Organization : Year 1999 ; Assessment Document, A68868. Retrieved from

Medical Reference Publication

The growing use of cost-effectiveness analysis to evaluate the efficiency of specific interventions is dominated by studies of prospective new interventions compared to current practice [1-11]. 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 maximises health for a given set of resource constraints. The estimated cost-effectiveness of a single proposed new intervention is compared either with the cost-effectiveness of a set of existing interventions derived from the literature [12-17] or with a fixed price cut-off point representing the assumed social willingness to pay for an additional unit of benefit [18-21]. The implicit assumption that the required additional resources would need to be transferred from another health intervention or from another sector is rarely discussed. On the other hand, much of the theoretical literature has taken a broader view of cost-effectiveness, exploring its use in allocating a fixed health budget between interventions in such a way as to maximise health in a society[22-34]. This we call sectoral cost-effectiveness analysis. Only a few applications of this broader use - in which a wide range of preventive, curative and rehabilitative interventions that benefit different groups within a population are compared in order to derive implications for the optimal mix of interventions - can be found. Examples include the work of the Oregon Health Services Commission [35-40], the World Bank Health Sector Priorities Review [41] and the Harvard Life Saving Project [42,43]. Of these, only the World Bank attempted to make international or global comparisons of sectoral costeffectiveness.

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