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Table 2 Summary of international published guidance

From: Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues

Source of published guidance

Key points

Theoretical paradigm underpinning guidance

World Bank (1993) [27]

The World Bank produced guidance focused on using techniques of economic evaluation to select a cost-effective package of healthcare interventions in developing countries.

The authors here write from the perspective of extra-welfarism, as they promote the use of cost-effectiveness analysis in their study.

World Health Organisation (2003) [28]

The World Health Organisation advocate use of a generalised cost-effectiveness analysis approach, where the comparator is ‘doing nothing’, as opposed to the more conventional ‘usual practice’.

The authors here write from the perspective of extra-welfarism as they promote the use of cost-effectiveness analysis in their study although they propose an alternative approach in terms of a generalised cost-effectiveness analysis.

Honeycutt et al. (2006) [29]

A practical ‘step-by-step’ guide to conducting cost-effectiveness analyses of public health interventions. These steps include defining the study question, identifying the study perspective, determining the time frame and analytic time period and selecting the type of economic study to conduct.

The authors focus on cost-effectiveness analysis and so it can be said that the theoretical underpinning here is extra-welfarism.

Mont and Loeb (2008) [30] Beyond DALYs: developing indicators to assess the impact of public health interventions on the lives of people with disabilities.

Aims to address a gap in the DALY approach by offering two public health relevant outcome measures 1) Activity limitation score 2) participation limitation score, based on data from Zambia.

The theoretical underpinning here is extra-welfarist since the report is concerned with improving health outcomes by using DALYs rather than mortality on its own.

OECD (2008) [31] The prevention of lifestyle related chronic diseases: an economic framework.

Focuses on the premise that prevention of chronic disease may increase social welfare and enhance health equity. This approach links chronic disease to the performance of markets and rationality failures, preventing individuals achieving the best possible outcomes. Focused on influencing choices available to individuals and seeking preventative mechanisms where market failures exist.

This approach is based on a behavioural economics theoretical framework focusing on rationality and market failure.

  1. Summary of international published guidance relevant to the economic evaluation of public health interventions.