Tag: Cost-Effectiveness

 

Health Technology Assessment: Global Advocacy and Local Realities

Blog Post

Cost-effectiveness analysis (CEA) can help countries attain and sustain universal health coverage (UHC), as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evidence about local values), whilst striving to strengthen the governance structures and technical capacities with which to generate, consider and act on such evidence. In low- and middle-income countries (LMICs), such capacities could be developed initially around a small technical unit in the health ministry or health insurer. The role of networks, development partners, and global norm setting organisations is crucial in supporting the necessary capacities.

Technology Won’t “Save” Healthcare

Blog Post

Health technologies can reduce healthcare spending. On average, they don’t. Prominent examples—like the way polio vaccines eliminated the need for iron lungs—seem to drive a common faith in healthcare technology as a tool to “cure” costly health systems. But it actually works the other way around—health systems (policies, institutions, and markets) and human responses to them determine whether these tools will (or won’t) increase spending.

Global Fund Executive Director Reboot

Blog Post

This week, the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria was set to name the organization’s new executive director. Instead, after the shortlist of candidates appeared in the New York Times, some in the global health community anonymously expressed concerns about the selection process and its results—and the Board abruptly announced it would restart the process from scratch. As the executive director search reboots, I am looking for candidates that have clarity, concrete plans, and capacity to make progress in three areas—the big 3—that are essential to the Fund’s survival: results, efficiency, and money.

Global Health Fares (Relatively) Well in FY14 State and Foreign Ops Appropriations

Blog Post

What do the US Congress, the US Senate and the White House have in common?  (This isn’t a trick question).  Both the House and the Senate matched the President’s FY14 request for global AIDS spending, including $4.02 billion for the President’s Emergency Plan for AIDS Relief (PEPFAR) and $1.65 for the Global Fund – marking a rare sweet spot where the executive and legislative branches agree.

Experimentation for Better Health: Lessons from the US for Global Health

Blog Post

In recent weeks, the public health world and political pundits alike have been abuzz about results from the “Oregon Experiment,” a study published in the New England Journal of Medicine that finds no statistical link between expanded Medicaid coverage and health outcomes such as high cholesterol or hypertension. Limitations of the study aside, the Oregon Experiment is a good example of the importance of rigorously testing all US health programs, rather than just assuming ‘more care = better health’.  The Innovation Center at the United States Centers for Medicaid and Medicare Services, created under the umbrella of the Affordable Care Act, represents a new and encouraging approach to address this problem, an approach that we think has important lessons for global health.

How Much Health Foregone?

Blog Post

When national governments or global health funders have to decide whether to subsidize a new medical technology (a new vaccine, a new AIDS medication, a new clinical pathway), some ask whether the new technology is “cost-effective”, that is, whether the health gains from the introduction of the new technology outweigh the health given up or foregone as other activities are displaced to accommodate the additional costs.

When and How Much TasP Is Value for Money?

Blog Post

This is a joint post with Mead Over and Denizhan Duran.

In mid-2011, one of the biggest developments in HIV/AIDS research took place. The HPTN 052 study found that early antiretroviral therapy treatment could reduce HIV transmission by 96% in couples where one partner is HIV positive and the other is HIV negative. The study was heralded as the breakthrough of 2011 by Science, and was hailed as a game changer by many others, including UNAIDS, The Economist and The Lancet. The World Health Organization wrote a comprehensive guideline for TasP, or treatment as prevention, in June 2012, asserting that “TasP needs to be considered as a key element of combination HIV prevention and as a major part of the solution to ending the HIV epidemic.”

Pages