What is the value of explicit priority setting for health interventions? A simulation study.

Area of Science:

• Health Economics
• Health Policy
• Public Health

Background:

• Many countries implement explicit priority setting institutions (PSIs) to enhance health spending efficiency.
• The value of PSIs is questioned due to resource diversion from direct patient services.

Purpose of the Study:

• To evaluate the cost-effectiveness and health benefits of implementing explicit priority setting institutions (PSIs).
• To compare funding decisions based on cost-effectiveness thresholds versus a no-PSI scenario.

Main Methods:

• Comparative simulation modeling was used to assess two funding approaches: one with an active PSI and a counterfactual without a PSI.
• The model was applied to datasets from the United Kingdom (2015) and Malawi (2018).

Main Results:

• The threshold rule, enabled by an active PSI, consistently led to decreased health system costs and/or improved health benefits.
• Indicative results from the UK and Malawi datasets support the effectiveness of PSI-guided funding.

Conclusions:

• Explicit priority setting institutions (PSIs) demonstrate added value by optimizing health spending.
• The developed user-friendly Excel model and guide are publicly available for local adaptation and further research.