Evidence map›Paper›PMID 28237196›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2017

Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

Richard Cookson, Andrew J Mirelman, Susan Griffin, Miqdad Asaria, Bryony Dawkins, Ole Frithjof Norheim, Stéphane Verguet, Anthony J Culyer

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 173 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
173citing papers in PubMed, 14 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

173 citing papers in PubMed, 14 syntheses or guidelines pooled it.

  1. Assessing Value for Money in Theranostic Nuclear Medicine: A Systematic Review.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026
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  6. A Systematic Review of the Cost-Effectiveness of Cleft Care in Low- and Middle-Income Countries: What is Needed?The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2023
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  9. A Systematic Review of Economic Evaluations of COVID-19 Interventions: Considerations of Non-Health Impacts and Distributional Issues.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022
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  12. How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2020
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  19. Distributional Cost-Effectiveness Analysis Using Microsimulation in R: A Tutorial.Medical decision making : an international journal of the Society for Medical Decision Making · 2026
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113 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

8 authors.

Richard CooksonCentre for Health Economics, University of York, York, UK. Electronic address: richard.cookson@york.ac.uk.
Andrew J MirelmanCentre for Health Economics, University of York, York, UK.
Susan GriffinCentre for Health Economics, University of York, York, UK.
Miqdad AsariaCentre for Health Economics, University of York, York, UK.
Bryony DawkinsAcademic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Ole Frithjof NorheimDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Stéphane VerguetDepartment of Global Health and Population, Harvard University, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Anthony J CulyerCentre for Health Economics, University of York, York, UK.

Funding

Department of Health SRF-2013-06-015
6 · The paper itself

Abstract

This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and-crucially-who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs.

Indexed as

Health EquityCost-Benefit AnalysisHumansPolicy MakingTechnology Assessment, Biomedicalcost-effectiveness analysisdelivery of health carehealth equitytechnology assessment

Identifiers

PMID28237196
PMCPMC5340318

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.