Imperial College London
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DrRanjeetaThomas

Faculty of Medicine, School of Public Health

Honoray Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 0923ranjeeta.thomas

 
 
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Location

 

LG 33AMedical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hauck:2016:10.1080/23288604.2015.1124170,
author = {Hauck, KD and Thomas, R and Smith, PC},
doi = {10.1080/23288604.2015.1124170},
journal = {Health Systems & Reform},
pages = {61--70},
title = {Departures from cost-effectiveness recommendations: The impact of health system constraints on priority setting},
url = {http://dx.doi.org/10.1080/23288604.2015.1124170},
volume = {2},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The methods and application of cost-effectiveness analysis have reached an advanced stage of development. Many decision makers consider cost-effectiveness analysis to be a valid and feasible approach towards setting health priorities, and it has been extensively applied in evaluating interventions and developing evidence based clinical guidelines. However, the recommendations arising from cost-effectiveness analysis are often not implemented as intended. A fundamental reason for the failure to implement is that CEA assumes a single constraint, in the form of the budget constraint, whilst in reality decision-makers may be faced with numerous other constraints. The objective of this paper is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance; and political constraints. Where possible -and if applicable- for each class of constraint, the paper discusses ways in which these constraints can be taken into account by a decision maker wishing to pursue the principles of cost-effectiveness.
AU  - Hauck,KD
AU  - Thomas,R
AU  - Smith,PC
DO  - 10.1080/23288604.2015.1124170
EP  - 70
PY  - 2016///
SN  - 2328-8604
SP  - 61
TI  - Departures from cost-effectiveness recommendations: The impact of health system constraints on priority setting
T2  - Health Systems & Reform
UR  - http://dx.doi.org/10.1080/23288604.2015.1124170
UR  - http://hdl.handle.net/10044/1/29382
VL  - 2
ER  -
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