Disease control priorities in developing countries. 2nd edition. Chapter 15. Cost-effectiveness analysis for priority setting.


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16 p, ill

What cost-effectiveness analysis (CEA) does and does not provide, how it is related to the concept of burden of disease, and how it can be used, along with other criteria, in setting priorities is discussed. The several meanings of the term CEA and the way that interventions are classified and evaluated are described. Estimating the effectiveness of an intervention requires specifying the units which in turn requires choices of several parameter values, including, in the analyses reported here, the discount rate applied to future years; the disability weights that describe the severity of diseases and conditions, corresponding to the health losses that they cause; and the life expectancy at different ages. Costs of interventions to include in the analysis, and conversion of costs to equivalents in U.S. dollars for international comparisons are described. Variations of results and uncertainty of estimates are discussed. Two ways are suggested to consider costs and outcomes at the population level, allowing for large differences among countries in the size of population; the incidence or prevalence of a disease, condition, or risk factor; and the amount spent or available to spend on an intervention

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