Using economic evidence to set healthcare priorities in low-income and lower-middle-income countries: a systematic review of methodological frameworks
File(s)Wiseman_et_al-2016-Health_Economics.pdf (296.87 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of ‘efficiency’ defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence.
Date Issued
2016-01-25
Date Acceptance
2015-10-26
Citation
Health Economics, 2016, 25 Suppl 1, pp.140-161
ISSN
1099-1050
Publisher
Wiley
Start Page
140
End Page
161
Journal / Book Title
Health Economics
Volume
25 Suppl 1
Copyright Statement
© 2016 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
License URL
Sponsor
Medical Research Council (MRC)
Grant Number
MR/K010174/1B
Subjects
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Economics
Health Care Sciences & Services
Health Policy & Services
Business & Economics
priority setting
low-income and lower-middle-income countries
developing countries
economic evaluation
MILLENNIUM DEVELOPMENT GOALS
COST-EFFECTIVENESS ANALYSIS
MARGINAL ANALYSIS
BALANCE-SHEET
INTERVENTIONS
STRATEGIES
GUIDELINES
AGREEMENT
DISEASE
EQUITY
14 Economics
11 Medical And Health Sciences
Publication Status
Published