A Brownbag Seminar
Health Strategies International
James G. Kahn
University of California, San Francisco
Center for Global Development
Determining which health interventions represent good value for money and are therefore good investments is an ongoing challenge for policymakers. A common approach to making these decisions has involved the use of thresholds based on per capita GDP. Specifically, many countries follow the World Health Organization’s Choosing Interventions that are Cost-Effective (WHO-CHOICE) project’s recommendation: an intervention that, per disability-adjusted life year (DALY) averted, costs less than three times the national annual GDP per capita is considered cost-effective.
Elliot Marseille and James Kahn, however, say this approach has major shortcomings. During this session, they made the case that the WHO-CHOICE thresholds are not useful for most decision-making in public health because they set the bar for cost-effectiveness too low, omit any consideration of what is truly affordable, and skirt the difficult but necessary ranking of the relative values of locally-applicable interventions. Marseille and Kahn offered alternative approaches for applying cost-effectiveness criteria to choices in the allocation of health-care resources.
- Marseille, Larson, Kazi, Kahn, and Rosen, 2015. Thresholds for the Cost-Effectiveness of Interventions Alternative Approaches
- Over, 2011. Achieving an AIDS Transition
- Meyer-Rath, Over, Klein, Bershteyn, 2015. The Cost and Cost-Effectiveness of Alternative Strategies to Expand Treatment to HIV Positive South Africans
- Glassman, Fan, and Over, 2013. More Health for the Money
- Marseille and Morshed, 2014. Essential surgery is CE in resource-poor countries
- Marseille et al. 2012. Taking ART to scale