Skip to main content
SpringerLink
Log in

Health Economics: Tools to Measure and Maximize Programme Impact

  • Chapter
  • First Online:
The Palgrave Handbook of Global Health Data Methods for Policy and Practice

  • 678 Accesses

Abstract

Kahn, Mwai, Kazi, and Marseille explain how economics brings together estimates of disease burden and the costs needed to reduce that burden so that policymakers can choose which intervention strategies will maximize health gains with available resources. The authors introduce and illustrate key health economics methods, including econometrics, cost-benefit analysis, micro-costing, behavioural economics, work force projections, financing, and discrete choice experimentation. They describe methods for calculating Disability-Adjusted Life Years, a standard summary metric that combines health losses due to mortality and morbidity, thus permitting comparison and summation across diseases and populations. The authors explain cost-effectiveness analysis, which compares health intervention costs with reductions in burden of disease, yielding the widely used Incremental Cost-Effectiveness Ratio, and discuss the ethical underpinnings of cost-effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Health24. Voluntary circumcision can cut new HIV infections by half. 2016 [cited 2018 5th February]. Available from: https://www.health24.com/News/Public-Health/voluntary-circumcision-can-cut-new-hiv-infections-by-half-20160607

  2. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Medicine. 2005 Oct 25;2(11):e298. Available from: http://dx.doi.org/10.1371/journal.pmed.0020298

  3. Kahn JG, Marseille E, Auvert B. Cost-effectiveness of male circumcision for HIV prevention in a South African setting. PLoS Medicine. 2006;3(12):e517.

    Article  Google Scholar 

  4. United Nations. Sustainable Development Goals. Goal 3: Ensure healthy lives and promote well-being for all at all ages. [cited 2018 20th February]. Available from: http://www.un.org/sustainabledevelopment/health/

  5. Wikipedia. Health Economics. 2009 [cited 2018 5th February]. Available from: https://en.wikipedia.org/wiki/Health_economics

  6. Shearer J, Shanahan M. Cost effectiveness analysis of smoking cessation interventions. Australian and New Zealand Journal of Public Health. 2006 Oct;30(5):428–34. Available from: http://dx.doi.org/10.1111/j.1467-842x.2006.tb00458.x

  7. World Health Organization. World Health Organization guide for standardization of economic evaluations of immunization programmes. 2008 [cited 2018 5th February]. Available from: http://www.who.int/immunization/research/implementation/who_ivb_08_14.pdf

  8. Gunda R, Chimbari MJ. Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review. Cost Effectiveness and Resource Allocation. 2017 Jul 1;15(1). Available from: http://dx.doi.org/10.1186/s12962-017-0072-9

  9. Bendavid E, Bhattacharya J. The relationship of health aid to population health improvements. Journal of the American Medical Association Internal Medicine. 2014 Jun 1;174(6):881. Available from: http://dx.doi.org/10.1001/jamainternmed.2014.292

  10. Keen S, Begum H, Friedman HS, James CD. Scaling up family planning in Sierra Leone: A prospective cost–benefit analysis. Women’s Health. 2017 Aug 29;13(3):43–57. Available from: http://dx.doi.org/10.1177/1745505717724617

  11. Bautista-Arredondo S, Sosa-Rubí SG, Opuni M, Contreras-Loya D, Kwan A, Chaumont C, et al. Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission. AIDS. 2016;30(16):2495.

    Article  Google Scholar 

  12. Shuval K, Leonard T, Drope J, Katz DL, Patel AV, Maitin-Shepard M, et al. Physical activity counseling in primary care: Insights from public health and behavioral economics. A Cancer Journal for Clinicians. 2017; 67(3):233–44.

    Google Scholar 

  13. Cohen J, Dupas P. Free distribution or cost-sharing? Evidence from a randomized malaria prevention experiment. The Quarterly Journal of Economics. 2010 Feb;125(1):1–45. Available from: http://dx.doi.org/10.1162/qjec.2010.125.1

  14. Augustincic Polec L, Petkovic J, Welch V, Ueffing E, Tanjong Ghogomu E, Pardo Pardo J, et al. Strategies to increase the ownership and use of insecticide-treated bednets to prevent malaria. Cochrane Database of Systematic Reviews. 2015 Mar 30;(3). Available from: http://dx.doi.org/10.1002/14651858.CD009186.pub2

  15. Kruk ME, Riley PL, Palma AM, Adhikari S, Ahoua L, Arnaldo C, et al. How can the health system retain women in HIV treatment for a lifetime? A discrete choice experiment in Ethiopia and Mozambique. PLoS One. 2016 Aug 23;11(8):e0160764. Available from: http://dx.doi.org/10.1371/journal.pone.0160764

  16. Institute of Health Metrics and Evaluation (IHME). [cited 2018 5th February]. Available from: http://www.healthdata.org/gbd

  17. Goodell AJ, Kahn JG, Ndeki SS, Kaale E, Kaaya EE, Macfarlane SB. Modeling solutions to Tanzania’s physician workforce challenge. Global Health Action. 2016;9(1):31597. Available from: http://dx.doi.org/10.3402/gha.v9.31597

  18. World Health Organization. Action to avert an 18-million health-worker shortfall announced at the 4th Human Resources for Health Forum in Dublin. [cited 2018 5th February]. Available from: http://www.who.int/hrh/en/

  19. GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep;390(10100):1260–344. Available from: http://dx.doi.org/10.1016/s0140-6736(17)32130-x

  20. World Health Organization. WHO methods and data sources for global burden of disease estimates 2000–2015. 2017 [cited 2018 4th March]. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalDALYmethods_2000_2015.pdf

  21. United Nations Department of Economic and Social Affairs Population Division. World population prospects: The 2012 revision, highlights and advance tables. ESA/P/WP.228. 2013 [cited 2018 4th March]. Available from: https://esa.un.org/unpd/wpp/Publications/

  22. Salomon JA, Haagsma JA, Davis A, de Noordhout CM, Polinder S, Havelaar AH, et al. Disability weights for the Global Burden of Disease 2013 Study. Lancet Global Health. 2015;3(11):e712–e23. Available from: http://dx.doi.org/10.1016/S2214-109X(15)00069-8

  23. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223. Available from: http://dx.doi.org/10.1016/S0140-6736(12)61689-4.

  24. Bognar G. Age-weighting. Economics and Philosophy. 2008 Jul;24(02). Available from: http://dx.doi.org/10.1017/s026626710800179x

  25. Kahn JG. The DALY show: YouTube. [cited 2018 20th February]. Available from: https://www.youtube.com/watch?v=Exce4gy7aOk

  26. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. Lancet. 2013 Dec;382(9908):1898–955. Available from: http://dx.doi.org/10.1016/s0140-6736(13)62105-4

  27. Kahn JG, Marseille EA. A saga in international HIV policy modeling: preventing mother-to-child HIV transmission. Journal of Policy Analysis and Management. 2002;21(3):499–505. Available from: http://dx.doi.org/10.1002/pam.10060

  28. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford, UK: Oxford University Press; 2015.

    Google Scholar 

  29. Weinstein MC, Stason WB. Foundations of cost-effectiveness analysis for health and medical practices. New England Journal of Medicine. 1977 Mar 31;296(13):716–21. Available from: http://dx.doi.org/10.1056/nejm197703312961304

  30. Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. Journal of the American Medical Association. 2016 Sep 13;316(10):1093–103. Available from: http://dx.doi.org/10.1001/jama.2016.12195

  31. Garber AM. Advances in cost-effectiveness analysis of health interventions. Working Paper 7198. National Bureau of Economic Research. 1999 [cited 2018 18th August]. Available from: http://www.nber.org/papers/w7198.pdf

  32. Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the Panel on Cost-effectiveness in Health and Medicine. Journal of the American Medical Association. 1996;276(15):1253–8.

    Article  CAS  Google Scholar 

  33. Global Health Decisions. Evaluating what works reviews. [cited 2018 5th February]. Available from: http://globalhealthdecisions.org/wwr/

  34. Chahal HS, Marseille EA, Tice JA, Pearson SD, Ollendorf DA, Fox RK, et al. Cost-effectiveness of early treatment of hepatitis C virus genotype 1 by stage of liver fibrosis in a US treatment-naive population. Journal of the American Medical Association Internal Medicine. 2016 Jan 1;176(1):65. Available from: http://dx.doi.org/10.1001/jamainternmed.2015.6011

  35. Granich R, Kahn JG, Bennett R, Holmes CB, Garg N, Serenata C, et al. Expanding ART for treatment and prevention of HIV in South Africa: estimated cost and cost-effectiveness 2011–2050. PLoS One. 2012 Feb 13;7(2):e30216. Available from: http://dx.doi.org/10.1371/journal.pone.0030216

  36. Goodell AJ, Shete PB, Vreman R, McCabe D, Porco TC, Barry PM, et al. Prospects for elimination: An individual-based model to assess tuberculosis control strategies in California. American Journal of Respiratory and Critical Care Medicine. 2016;193:A7678. [cited 2018 5th November]. Available from: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A7678

  37. Marseille E, Larson B, Kazi DS, Kahn JG, Rosen S. Thresholds for the cost–effectiveness of interventions: alternative approaches. Bulletin of the World Health Organization. 2014 Dec 15;93(2):118–24. Available from: http://dx.doi.org/10.2471/blt.14.138206

  38. Birch S, Gafni A. Cost-effectiveness ratios: in a league of their own. Health Policy. 1994 May;28(2):133–41. Available from: http://dx.doi.org/10.1016/0168-8510(94)90031-0

  39. Keeney RL, Raiffa H. Decisions with multiple objectives: preferences and value trade-offs. Oxford, UK: Cambridge University Press; 1993.

    Book  Google Scholar 

  40. Johannesson M, Weinstein MC. On the decision rules of cost-effectiveness analysis. Journal of Health Economics. 1993 Dec;12(4):459–67. Available from: http://dx.doi.org/10.1016/0167-6296(93)90005-y

  41. Karlsson G, Johannesson M. The decision rules of cost-effectiveness analysis. Pharmacoeconomics. 1996 Feb;9(2):113–20. Available from: http://dx.doi.org/10.2165/00019053-199609020-00003

  42. Gift TL, Malotte CK, Ledsky R, Hogben M, Middlestadt S, VanDevanter NL, et al. A cost-effectiveness analysis of interventions to increase repeat testing in patients treated for gonorrhea or chlamydia at public sexually transmitted disease clinics. Sexually Transmitted Diseases. 2005 Sep;32(9):542–9. Available from: http://dx.doi.org/10.1097/01.olq.0000175414.80023.59

  43. Maciosek MV, Edwards NM, Coffield AB, Flottemesch TJ, Nelson WW, Goodman MJ, et al. Priorities among effective clinical preventive services. American Journal of Preventive Medicine. 2006 Jul;31(1):90–6. Available from: http://dx.doi.org/10.1016/j.amepre.2006.03.011

  44. World Health Organization. Making fair choices on the path to universal health coverage. Final report of the WHO Consultative Group on Equity and Universal Health Coverage. 2014 [cited 2018 20th February]. Available from: http://apps.who.int/iris/bitstream/10665/112671/1/9789241507158_eng.pdf?ua=1

  45. Macklin R, Cowan E. Given financial constraints, it would be unethical to divert antiretroviral drugs from treatment to prevention. Health Affairs. 2012 Jul;31(7):1537–44. Available from: http://dx.doi.org/10.1377/hlthaff.2012.0071

  46. McKie J, Richardson J. The rule of rescue. Social Science & Medicine. 2003 Jun;56(12):2407–19. Available from: http://dx.doi.org/10.1016/s0277-9536(02)00244-7

Download references

Author information

Authors and Affiliations

  1. Institutes for Health Policy Studies and Global Health Sciences, University of California San Francisco, San Francisco, CA, USA

    James G. Kahn

  2. Health Policy Plus, Palladium Group, Nairobi, Kenya

    Daniel Mwai

  3. Health Economics Unit, School of Economics, University of Nairobi, Nairobi, Kenya

    Daniel Mwai

  4. Richard F. and Susan A. Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Dhruv Kazi

  5. Health Strategies International, Oakland, CA, USA

    Elliot Marseille

Authors
  1. James G. Kahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Mwai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dhruv Kazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elliot Marseille
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Epidemiology and Biostatistics School of Medicine, and Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA

    Sarah B. Macfarlane

  2. CAZ Consulting Sarl, Bloomberg Data for Health Initiative, Geneva, Switzerland

    Carla AbouZahr

Copyright information

© 2019 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kahn, J.G., Mwai, D., Kazi, D., Marseille, E. (2019). Health Economics: Tools to Measure and Maximize Programme Impact. In: Macfarlane, S., AbouZahr, C. (eds) The Palgrave Handbook of Global Health Data Methods for Policy and Practice. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-54984-6_19

Download citation

  • DOI: https://doi.org/10.1057/978-1-137-54984-6_19

  • Published:

  • Publisher Name: Palgrave Macmillan, London

  • Print ISBN: 978-1-137-54983-9

  • Online ISBN: 978-1-137-54984-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation