Country contextualisation of cost-effectiveness studies: lessons from Ethiopia.

摘要: Emerging demographic, epidemiological and health system changes in low-income countries require revisions of national essential services packages accordance with standard healthcare priority setting methods. Policy makers are need explicit user-friendly methods to compare impact multiple interventions. We provide experiences country contextualisation WHO-CHOICE models a level. Results from three contextualised cost-effectiveness analyses (CEAs) presented, we discuss how this evidence can inform Ethiopia. Existing for range interventions obstetric neonatal care, psychiatric neurological treatment prevention cardiovascular diseases the Ethiopian setting. CEAs defined as if they include analysts use country-specific input either costs, epidemiology, demography, baseline coverage or effects. Interventions (n=61) ranked according incremental rates (ICERs), expected outcomes (Disability Adjusted Life Years (DALYs) averted) budget impacts presented each intervention. Dominated (n=30) were excluded. A US$2.8 increase per capita annual is needed Ethiopia (currently at US$28 capita) increasing by 20%–75% all 22 positive net benefits. This investment give benefit around 0.5 million DALYs averted return total, willingness pay threshold US$2000 DALY averted. In particular, interventions, resuscitation, kangaroo mother care antibiotics newborn sepsis, stand out best buys an Our method provides important information policy makers. Rank ordering ICERs, together presentations benefits, clear friendly illustration possible efficient stepwise pathways towards universal coverage.