Tools for Policy Analysis: Costing and Cost-Effective Analysis

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Tools for Policy AnalysisCosting and
Cost-Effective Analysis

• Group 3
• Selection of the Priority Health Project(s) for
  Investment

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• Head of the group
• Dr Ali Khadr
• Rapporteur
• Dr Mohammad Ali Khalifa
• Facilitator
• Dr Sameen Siddiqi
• Group members
• Dr Bothaina Attal
• Dr Sanaa Naffa
• Dr Ishtawi Abu Zayed
• Dr Riham Asady
• Dr Kushkhal Khan
• Dr Ali Khadr
• Dr Akihiro Seita
• Dr Besrat Hagos
• Dr Nasr El Tantawy

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• Exercise elements
• MoF releases 10 million to MoH for investment
  in priority areas
• Very short notice
• The unspent money will be lost
• A list of projects is prepared by MoH
• Selection by a decision making committee

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Project Total DALYs averted Number of people affected Cost in C/B Ratio
A 1000 100,000 5,000,000 5000
B 1000 50 5,000,000 5000
C 2000 1000 10,000,000 5000
D 1000 20 4,000,000 4000
E 10,000 500,000 1,000,000 100
F 40 20 4,000,000 100,000
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• Role Play by the group members

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• Issues raised and discussed during the selection
  process
• Two scenarios
• (1) Business as usual approach
• 1- Timeline very limited (as soon as possible,
  otherwise the money will be lost, very limited
  time for planning)
• 2- Was it a trick by the MoF ?
• 3- Was there a hidden agenda behind this very
  short notice?
• 4- The money will be used by interest and
  pressure groups to be directed towards
  pre-defined areas ?

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• (2) Revolutionary new approach
• To adopt scientific criteria
• 1- Total DALYs averted by the selected project(s)
• 2- Number of people affected by the selected
  project(s)
• 3- Cost effective analysis
• 4- Ethical issues

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• Decision

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Project Total DALYs averted Number of people affected Cost in C/B Ratio
A 1000 100,000 5,000,000 5000
B 1000 50 5,000,000 5000
C 2000 1000 10,000,000 5000
D 1000 20 4,000,000 4000
E (1st) 10,000 500,000 1,000,000 100
F 40 20 4,000,000 100,000
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• 1st Choice Project E
• Justification
• The largest number of beneficiaries
• The highest total DALYs averted
• The most effective cost for total DALYs
• averted
• Possible epidemic which needs prompt intervention
  (e.g viral hepatitis A) ???

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Project Total DALYs averted Number of people affected Cost in C/B Ratio
A 1000 100,000 5,000,000 5000
B 1000 50 5,000,000 5000
C 2000 1000 10,000,000 5000
D (2nd) 1000 20 4,000,000 4000
E 10,000 500,000 1,000,000 100
F 40 20 4,000,000 100,000
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• 2nd Choice Project D
• Justification
• The next most effective cost for total
• DALYs averted
• It was selected for ethical reasons considering
  the seriousness of the expected health problem
  and its catastrophic effect on public health and
  population if it is not controlled and eliminated
  within a very short time. This justifies the
  selection despite the apparently very limited
  number of beneficiaries.
• Possibly child leukemia

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Project Total DALYs averted Number of people affected Cost in C/B Ratio
A (3rd) 1000 100,000 5,000,000 5000
B 1000 50 5,000,000 5000
C 2000 1000 10,000,000 5000
D 1000 20 4,000,000 4000
E 10,000 500,000 1,000,000 100
F 40 20 4,000,000 100,000
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• 3rd Choice Project A
• Justification
• It ranks the 3rd with regard C/B ratio
• The 2nd largest number of beneficiaries
• Possibly elderly pneumonia

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Project Total DALYs averted Number of people affected Cost in C/B Ratio
A 1000 100,000 5,000,000 5000
B 1000 50 5,000,000 5000
C (???) 2000 1000 10,000,000 5000
D 1000 20 4,000,000 4000
E 10,000 500,000 1,000,000 100
F 40 20 4,000,000 100,000
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Project How many cases expected to be prevented per 1000 population with each project selection?
A 10 per 1000
B 20,000 per 1000
C 2000 per 1000
D 50,000 per 1000
E 20 per 1000
F 2000 per 1000
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Thank you