Evidence map›Paper›PMID 19888791›Full record

ReviewPharmacoEconomics2009

Cost effectiveness in low- and middle-income countries: a review of the debates surrounding decision rules.

Samuel D Shillcutt, Damian G Walker, Catherine A Goodman, Anne J Mills

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in PharmacoEconomics, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

109 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression.The European journal of health economics : HEPAC : health economics in prevention and care · 2022
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49 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Samuel D ShillcuttDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. samuel.shillcutt@gmail.com
Damian G Walker
Catherine A Goodman
Anne J Mills

Funding

Wellcome Trust
6 · The paper itself

Abstract

Cost-effectiveness analysis (CEA) is increasingly important in public health decision making, including in low- and middle-income countries. The decision makers' valuation of a unit of health gain, or ceiling ratio (lambda), is important in CEA as the relative value against which acceptability is defined, although values are usually chosen arbitrarily in practice. Reference case estimates for lambda are useful to promote consistency, facilitate new developments in decision analysis, compare estimates against benefit-cost ratios from other economic sectors, and explicitly inform decisions about equity in global health budgets. The aim of this article is to discuss values for lambda used in practice, including derivation based on affordability expectations (such as $US150 per disability-adjusted life-year [DALY]), some multiple of gross national income or gross domestic product, and preference-elicitation methods, and explore the implications associated with each approach. The background to the debate is introduced, the theoretical bases of current values are reviewed, and examples are given of their application in practice. Advantages and disadvantages of each method for defining lambda are outlined, followed by an exploration of methodological and policy implications.

Indexed as

Policy MakingCost-Benefit AnalysisDeveloping CountriesEconomicsHealth PolicyHumansQuality-Adjusted Life Years

Identifiers

PMID19888791
PMCPMC2810517

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.