Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

Area of Science:

• Health Economics
• Public Health Policy
• Health Equity Research

Background:

• Conventional cost-effectiveness analysis (CEA) prioritizes maximizing overall health outcomes.
• Addressing health equity requires evaluating how interventions impact different population subgroups.
• Potential conflicts exist between maximizing total health and achieving equitable health outcomes.

Purpose of the Study:

• To provide a guide on integrating health equity considerations into cost-effectiveness analysis (CEA).
• To introduce the "equity impact plane" for visualizing trade-offs between health gains and equity objectives.
• To outline methods for conducting equity-informative CEA for policymakers.

Main Methods:

• Introduction of the "equity impact plane" for analyzing trade-offs.
• Description of equity impact analysis: quantifying distributions by equity-relevant variables (e.g., socioeconomic status, ethnicity, illness severity).
• Description of equity trade-off analysis: quantifying trade-offs using methods like health forgone or equity weights.

Main Results:

• Cost-effectiveness analysis can be adapted to address health equity concerns.
• Equity impact analysis reveals how costs and benefits are distributed across different groups.
• Equity trade-off analysis quantifies the health consequences of prioritizing fairness.

Conclusions:

• The "equity impact plane" and described methods offer practical tools for equity-informative CEA.
• Equity-informative CEA enhances understanding of health program impacts on different populations.
• This approach supports policymakers in making more equitable health resource allocation decisions.