A number of methodological developments have taken place within the field of economic evaluation in recent years.
However, these have primarily been motivated by, and tailored towards, meeting health care needs in higher income countries – particularly in the UK and related to the work of the National Institute for Health and Care Excellence (NICE). A diverse and varied set of challenges exist in low- and middle-income country (LMIC) settings.
CHE is engaged in leading the development and supporting the uptake of economic evaluation methods in LMICs. We work with partners to explore how methods can be appropriately used by priority setting institutions.
The Bill and Melinda Gates Foundation (BMGF) is a major funder of health economic evaluation studies for low- and middle-income countries (LMICs) that aim to inform priorities at local and national levels, as well as for global health funders including the Foundation itself. However, the value of studies produced has perhaps been less than optimal due to variability in their quality and lack of consistency in methods.
CHE was engaged, as part of a team led by NICE International, to develop principles of best practice and a reference case for the application of economic evaluation in global health, as part of the Methods in Economic Evaluation Project (MEEP). The first MEEP report was published in 2014, and will be updated on an ongoing basis as methods are further developed.
- Bill and Melinda Gates Foundation, Methods for Economic Evaluation Project (MEEP) (PDF , 2,265kb)Final Report.
The International Decision Support Initiative (iDSI) was launched in 2014 in response to the report, by a number of leading global health experts, investigating whether the processes for priority setting in global health could be improved. iDSI was established to provide technical and consultative support to global funding agencies and developing country governments, on the methods to support effective resource allocation.
One of the key priority setting challenges iDSI sought to address was the need to determine methods for how relevant alternatives should be formally assessed. As a key partner, CHE has provided teaching and academic input on methods development in low- and middle-income country (LMIC) settings. CHE researchers also co-produced the iDSI Reference Case with colleagues at the Bill and Melinda Gates Foundation, NICE International, and the Health Intervention and Technology Assessment Program (HITAP).
CHE has been instrumental in the formation of the iDSI Methods Working Groups, and leads the Group researching cost-effectiveness thresholds estimation. The four ongoing research projects are investigating the practice, use and impact of economic evaluation studies to support decision making in LMICs.
- Revill P, Woods B, Sculpher M. Economic evaluation of healthcare programs and interventions: Applications to low- and middle-Income. In: Scheffler RM, (ed). World Scientific Handbook of Global Health Economics and Public Policy Volume 1 2015. More details
- Nakamura R, Lomas J, Bokhari F, Morena Serra R, Suhrcke M. Assessing the impact of health care expenditures on mortality using cross-country panel data. (forthcoming)
- Revill P, Ochalek J, Lomas J, Nakamura R, Woods B, Rollinger A, Suhrcke M, Sculpher M, Claxton K. Cost-effectiveness thresholds: guiding health care spending for population health improvement. (forthcoming)