Distributional Cost-Effectiveness Analysis: Quantifying Health Equity Impacts and Trade-Offs (Handbooks in Health Economic Evaluation)

Distributional Cost-Effectiveness Analysis: Quantifying Health Equity Impacts and Trade-Offs (Handbooks in Health Economic Evaluation)

Distributional cost-effectiveness analysis aims to help health care and public health organisations make fairer decisions with better outcomes. Whereas standard cost-effectiveness analysis provides information about total costs and effects, distributional cost-effectiveness analysis provides additional information about fairness in the distribution of costs and effects - who gains, who loses, and by how much. It can also provide information about the trade-offs that sometimes occur between efficiency objectives, such as improving total health, and equity objectives, such as reducing unfair inequality in health. This is a practical guide to a flexible suite of economic methods for quantifying the equity consequences of health programmes in high-, middle- and low-income countries. The methods can be tailored and combined in various ways to provide useful information to different decision-makers in different countries with different distributional equity concerns. The handbook is primarily aimed at postgraduate students and analysts specialising in cost-effectiveness analysis but is also accessible to a broader audience of health sector academics, practitioners, managers, policymakers and stakeholders. As well as offering an overview for research commissioners, users, and producers, the book includes systematic technical guidance on how to simulate and evaluate distributions, with accompanying hands-on spreadsheet training exercises, and discussions about how to handle uncertainty about facts and disagreement about values, and the future challenges facing this young and rapidly evolving field of study. "The authors are to be congratulated ... this is a good book in conception and execution" -- Sean Campbell Sinclair, Ethical Theory and Moral Practice "The definitive guide to equity methods in health economic evaluation - a landmark in the field." -- Michael Drummond, Professor of Health Economics, University of York, UK "A thorough and accessible overview; the introductory chapters should be part of any graduate-level course on health economic evaluation." -- Milton Weinstein, Research Professor of Health Policy and Management, Harvard University, USA "Essential reading for analysts in countries aiming at Universal Health Coverage - a major contribution to making equity count in priority-setting." -- Tessa-Tan-Torres Edejer, Coordinator, Economic Analysis and Evaluation, World Health Organization, Switzerland Richard Cookson, Professor, Centre for Health Economics, University of York, UK ,Susan Griffin, Senior Research Fellow, Centre for Health Economics, University of York, UK ,Ole F. Norheim, Professor, Department of Global Public Health, University of Bergen, Norway ,Anthony J. Culyer, Professor Emeritus, University of York, UK Richard Cookson is a professor at the Centre for Health Economics, University of York, England. He has helped to pioneer "equity-informative" methods of health policy analysis including methods of distributional cost-effectiveness analysis, methods of health equity monitoring for healthcare quality assurance, and methods for investigating public concern for reducing health inequality. He has co-chaired various international working groups on equity, and his UK public service includes working in the Prime Minister's Delivery Unit and serving on NICE advisory committees and the NHS Advisory Committee for Resource Allocation. Susan Griffin is a Senior Research Fellow at the Centre for Health Economics, University of York. Throughout her career, she has developed methods for economic evaluation and produced research that supports decision-makers investing in healthcare and health research to improve health and reduce health inequalities. Her research interests include the use of decision-analytic models in cost-effectiveness analysis and value of information analysis. Susan leads research on public health and health inequality in two policy research units for the Department of Health and Social Care in the UK. She has contributed to technology appraisals undertaken by the National Institute for Health and Care Excellence (NICE) as a member of one of the independent academic groups undertaking assessments and evidence reviews, as a member of the Technology Appraisal Committee, and in the development of methods used at NICE. Ole F. Norheim is a physician and professor of medical ethics, Department of Global Public Health and Primary Care, the University of Bergen, and adjunct professor of global health at the Department of Global Health and Population, Harvard TH Chan School of Public Health. He directs the Bergen Centre for Ethics and Priority Setting (BCEPS) at the University of Bergen. Norheim's wide-ranging research interests include theories of distributive justice, inequality in health, priority setting in health systems, and how to achieve Universal Health Coverage and the Sustainable Development Goal for health. Norheim chaired the World Health Organization's Consul