TY - JOUR T1 - Innovations in cost-effectiveness analysis that advance equity can expand its use in health policy JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-008140 VL - 7 IS - 2 SP - e008140 AU - Anton L.V. Avanceña AU - Lisa A Prosser Y1 - 2022/02/01 UR - http://gh.bmj.com/content/7/2/e008140.abstract N2 - Summary boxAround the world, cost-effectiveness analysis (CEA) is commonly used to evaluate the costs and health benefits of healthcare and public health interventions.While suitable to measure the efficiency of health interventions, conventional CEA does not consider health equity concerns that inform decision-making or resource allocation in health.Innovations in CEA, such as equity-informative CEA and alternatives to the quality-adjusted life year, are a step in the right direction and can improve the performance of health systems globally.By addressing efficiency and equity concerns concurrently, these innovations can reduce unjust health differences and advance a justice-oriented definition of value in health.Cost-effectiveness analysis (CEA) provides a useful framework to systematically assess and compare the expected costs and health benefits of two or more alternatives; it has been used around the world, often in the context of health technology assessments (HTAs), to promote efficiency of health systems. Coupled with a consultative process involving various stakeholders, CEA can help inform resource allocation, approval and coverage of medications and other interventions at the national level and prioritisation of patient populations who are most likely to benefit from an intervention, among other objectives. In a handful of countries including the UK, Australia, Thailand, CEA evidence produced by HTA agencies is used in price negotiation and value-based pricing.By considering cost-effectiveness evidence in their decisions, payers can identify low-value services and save significant resources while improving health outcomes.1 Several low-income and middle-income countries (LMICs) use CEA to achieve lower drug and vaccine costs and, increasingly, to design healthcare benefits packages for national health insurance programmes that prioritise cost-effective services.2 3 In the USA, where CEA evidence is not systematically used in, or is explicitly excluded from, healthcare decision-making, payers waste billions of dollars on low-value care. One study found that Medicare, the single largest … ER -