Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland.
Int J Health Policy Manag. 2021 Nov 1;10(11):670-672. doi: 10.34172/ijhpm.2021.105.
The WHO-CHOICE (World Health Organization CHOosing Interventions that are Cost-Effective) approach is unique in the global health landscape, as it takes a "generalized" approach to cost-effectiveness analysis (CEA) that can be seen as a quantitative assessment of current and future efficiency within a health system. CEA is a critical contribution to the process of priority setting and decision-making in healthcare, contributing to deliberative dialogue processes to select services to be funded. WHO-CHOICE provides regional level estimates of cost-effectiveness, along with tools to support country level analyses. This series provides an update to the methodological approach used in WHO-CHOICE and presents updated cost-effectiveness estimates for 479 interventions. Five papers are presented, the first focusing on methodological updates, followed by three results papers on maternal, newborn and child health; HIV, tuberculosis and malaria; and non-communicable diseases and mental health. The final paper presents a set of example universal health coverage (UHC) benefit packages selected through only a value for money lens, showing that all disease areas have interventions which can fall on the efficiency frontier. Critical for all countries is institutionalizing decision-making processes. A UHC benefit package should not be static, as the countries needs and ability to pay change over time. Decisions will need to be continually revised and new interventions added to health benefit packages. This is a vital component of progressive realization, as the package is expanded over time. Developing an institutionalized process ensures this can be done consistently, fairly, and transparently, to ensure an equitable path to UHC.
世界卫生组织选择可负担得起的干预措施（WHO-CHOICE）方法在全球卫生领域独具特色，它采用了一种“广义”的成本效益分析（CEA）方法，可以被视为对卫生系统内当前和未来效率的定量评估。CEA 是医疗保健中优先排序和决策制定过程的重要贡献，有助于选择要资助的服务的审议对话过程。WHO-CHOICE 提供了成本效益的区域水平估计，以及支持国家层面分析的工具。本系列提供了 WHO-CHOICE 中使用的方法学方法的更新，并提出了 479 项干预措施的更新成本效益估计。本系列共包含五篇论文，第一篇专注于方法学更新，随后三篇分别关注母婴、新生儿和儿童健康、艾滋病毒、结核病和疟疾以及非传染性疾病和精神卫生。最后一篇论文提出了一套通过仅关注性价比选择的通用健康覆盖（UHC）福利套餐示例，表明所有疾病领域都有可以落在效率前沿的干预措施。对所有国家来说，关键是将决策制定过程制度化。UHC 福利套餐不应是静态的，因为国家的需求和支付能力会随着时间的推移而变化。决策将需要不断修订，并向健康福利套餐中添加新的干预措施。这是逐步实现的重要组成部分，因为随着时间的推移，套餐会不断扩大。建立制度化的流程可确保以一致、公平和透明的方式做到这一点，以确保实现 UHC 的公平路径。
