Summary for Using Cost-Effectiveness Analysis Properly
Applying resources effectively means spending money on things that influence health, and this requires scientific knowledge about risk factors, diseases, biochemistry, social behavior, and so on, but this scientific knowledge alone does not determine which interventions will have the most impact. To determine the best allocation of public funds, policy makers need information about relative costs to determine what combination of interventions can yield the greatest improvements in health. Cost-effectiveness analysis is the tool for weighing different costs and health outcomes when policy makers have to make resource allocation decisions. It does this by giving policy makers the "price" of achieving health improvements through different kinds of interventions, and thereby helps them make decisions that get the most out of their financial resources.
Ultimately, knowing which interventions work and at what cost has to be tempered by knowledge of institutions and implementation. Only when scientific and practical knowledge are combined can policy makers identify the interventions that will have the most impact in practice. Thus the cost-effectiveness analyses presented in DCP2 and in this book provide an important contribution to broader debates about public policy decisions pertaining to health.
DCP2 compiles the best available evidence about the cost-effectiveness of different interventions. To use these numbers properly, readers should
-
consider the cost-effectiveness ratios reported for their regions as a first approximation and rank the interventions in broad categories
-
assess whether the calculated ratios would differ substantially in their countries because prices, demographics, epidemiology, or service coverage differ significantly from the regional average
-
consider whether the cost-effective interventions would address major sources of the disease burden in their countries
-
determine whether the cost-effective interventions would be feasible given existing institutions and experiences with implementation in their countries
-
evaluate the cost-effective interventions in terms of how they would distribute health improvements and whether this would be equitable in their countries.
At the conclusion of such a review of the international evidence, countries will be able to achieve better health for their people because they can explicitly assess the costs and consequences of different courses of action.
Notes
1 When price data were only available from a few countries in a region, DCP2 authors tried to select a price that was most likely to be representative of that region, even if it was not a calculated average.
