Cost effectiveness and strategic planning (WHO-CHOICE)

An overview of the rationale, activities and goals of WHO-CHOICE

Why do we need regional databases on intervention cost-effectiveness?

The pioneering effort of the World Bank’s Health Sector Priorities Review (HSPR) encouraged policy makers to incorporate evidence on the costs and effects of interventions into their decision-making. The HSPR focused on a limited number of interventions, the individual studies used different methodologies, and estimates of cost-effectiveness were produced only on a global basis. This makes it difficult for country policy makers to decide if the results across interventions were comparable, and if they were relevant to their settings.

Epidemiology, baseline levels of infrastructure, the history of disease control and health promotion, and cost structures vary across countries. So the costs and effectiveness of any health intervention will vary from one setting to the next. Consequently, a single "global average" estimate for an intervention’s cost-effectiveness is not of great value to policy-makers. However, the ideal of specific estimates for each intervention in every setting is not achievable in the short run. As a compromise, WHO-CHOICE is producing databases reporting the costs and effectiveness of interventions for 14 subregions that have been grouped together on the basis of epidemiology, infrastructure and economic situation.