Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data
Research output: Working paper › Discussion paper
Date | Published - Dec 2015 |
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Publisher | Centre for Health Economics, University of York |
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Place of Publication | York, UK |
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Number of pages | 50 |
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Original language | English |
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Name | CHE Research Paper |
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Publisher | Centre for Health Economics, University of York |
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No. | 122 |
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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.
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