ArticlePharmacoEconomics2014
Are current cost-effectiveness thresholds for low- and middle-income countries useful? Examples from the world of vaccines.
Article in PharmacoEconomics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05996549 (Acceptability, Cost-Effectiveness, and Capacity of a Facility-Based Seasonal Influenza Vaccination), which is not on this map. Cited by 55 papers, 6 of them syntheses that pooled 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.
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.
Acceptability, Cost-Effectiveness, and Capacity of a Facility-Based Seasonal Influenza Vaccination: A Study in Selected Hospitals of Bangladesh
Who cites it
55 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- A Systematic Review of Health Economic Evaluations and Budget Impact Analyses to Inform Healthcare Decision-Making in Central America.Applied health economics and health policy · 2023Pooled it
- Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs.Wellcome open research · 2020Pooled it
- Economic evaluations of onchocerciasis interventions: a systematic review and research needs.Tropical medicine & international health : TM & IH · 2019Pooled it
- Economic evaluations of lymphatic filariasis interventions: a systematic review and research needs.Parasites & vectors · 2018Pooled it
- Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework.PharmacoEconomics · 2018Pooled it
- A systematic review of health economic evaluations of vaccines in Brazil.Human vaccines & immunotherapeutics · 2017Pooled it
- Trial
- The Spatiotemporal Threshold Effects of Health Expenditure and Health Developmental Assistances on Health-Related Outcome in Sub-Saharan Africa Post Covid19: The Case of the Public-Private Partnerships Donors.The International journal of health planning and management · 2026Article
- The cost-effectiveness of Wolbachia-based biocontrol interventions for dengue: A scoping review of the available evidence.PLoS neglected tropical diseases · 2026Article
- The epidemiological burden and societal cost of 14 respiratory conditions in the World Health Organization European region: systematic evidence map and economic analysis.ERJ open research · 2026Article
- A Scoping Review Mapping Economic Evaluations of Midwifery Service Provision and the Midwifery Workforce.Applied health economics and health policy · 2025Article
- Acceptability, cost-effectiveness, and capacity of a facility-based seasonal influenza vaccination among high-risk groups: a study protocol in selected tertiary care hospitals of Bangladesh.BMC public health · 2024Article
- Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals: Case studies in the Indo-Pacific.PloS one · 2024Article
- Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population.Nature medicine · 2023Article
- The potential global cost-effectiveness of prospective Strep A vaccines and associated implementation efforts.NPJ vaccines · 2023Article
- Cost-Effectiveness Analysis of Integrated Bite Case Management and Sustained Dog Vaccination for Rabies Control.The American journal of tropical medicine and hygiene · 2023Article
- How Much Should be Invested in Lung Care Across the WHO European Region? Applying a Monetary Value to Disability-Adjusted Life-Years Within the International Respiratory Coalition's Lung Facts.Applied health economics and health policy · 2023Article
- Article
- Optimizing next-generation RSV prevention in Mali: A cost-effectiveness analysis of pediatric vaccination, maternal vaccination, and extended half-life monoclonal antibody immunoprophylaxis.PLOS global public health · 2023Article
- Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The World Health Organization's CHOosing Interventions that are Cost Effective (WHO-CHOICE) thresholds for averting a disability-adjusted life-year of one to three times per capita income have been widely cited and used as a measure of cost effectiveness in evaluations of vaccination for low- and middle-income countries (LMICs). These thresholds were based upon criteria set out by the WHO Commission on Macroeconomics and Health, which reflected the potential economic returns of interventions. The CHOICE project sought to evaluate a variety of health interventions at a subregional level and classify them into broad categories to help assist decision makers, but the utility of the thresholds for within-country decision making for individual interventions (given budgetary constraints) has not been adequately explored. To examine whether the 'WHO-CHOICE thresholds' reflect funding decisions, we examined the results of two recent reviews of cost-effectiveness analyses of human papillomavirus and rotavirus vaccination in LMICs, and we assessed whether the results of these studies were reflected in funding decisions for these vaccination programmes. We found that in many cases, programmes that were deemed cost effective were not subsequently implemented in the country. We consider the implications of this finding, the advantages and disadvantages of alternative methods to estimate thresholds, and how cost perspectives and the funders of healthcare may impact on these choices.
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Registered trials
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.