Cost-effectiveness analysis for priority-setting in South Africa - what are the possibilities?

Abstract

Priority-setting in the health system is necessary because resources are constrained. The role of cost-effectiveness analysis in supporting decision-making around health care priorities in South Africa is explored by referring to South African studies that have provided clinical and policy guidance at the levels of the patient, the service and the population. Cost-effectiveness evidence is positioned in relation to other concerns such as equity and the overall performance of the health system.

Assessing vaccine data recording in Brazil

“…However, although computers are already in use for the processing of vaccine administrative data in most of the world, for the most part procedures and routines for data transfer are still far from adequate 6,19,30 . Thus, the implementation of computerized tools for public health data processing is indeed necessary, but that this endeavor also requires a high commitment to the improvement of human resources, towards an effective management of information systems [31][32][33][34] .…”

Quo vadis healthcare quality assurance?

“…The possibilities of cost-effectiveness analysis (CEA) for prioritysetting in SA are explored by Jane Doherty. 7 She concludes that some capacity to undertake costing and CEA already exists and has influenced clinical decision making and policy. Possibilities of CEA to contribute further to decision making in SA include promotion of dialogue on health and health care priorities as well as affordability; advocacy against interventions that are clearly cost-ineffective and unaffordable (especially at central hospital level); advocacy for interventions that strengthen the district health system (because of the highly cost-effective nature of primary and district hospital care), including motivation for increased funding from Treasury; advocacy for acceptable pricing of drugs and vaccines; assessment of innovative new interventions, including those for emerging conditions; identifying clusters of interventions that can enhance the shared use of inputs, reduce costs to patients, achieve synergy between interventions, reach related individuals, and screen patients at the primary level to increase efficiency of referral; and clarification of the roles of different providers and levels of care.…”

Making Connections and Measuring Performance: Bibliometric Analysis of Multi-Attribute, Preference-Based Health-Related Quality of Life Research in South Africa

“…8,9 Additionally, HTA and costeffectiveness evaluations have been used in hospital settings to inform evidence-based decisions on introducing new technologies. [10][11][12][13][14] Yet there remains a need to strengthen HTAs in South Africa for healthcare resource allocation and priority setting, with individual and organizational capacity-building, national coordination, data infrastructure, and active regional and international research networks highlighted as areas to address. 13,15,16 With cost-effectiveness becoming increasingly important in South Africa for resource allocation decisions, a systematic review was conducted to identify South African-specific HRQoL studies that could inform CUAs.…”