Generalized Cost-Effectiveness Analysis (GCEA) Approach

The use of cost-effectiveness analysis within health decision making processes is increasingly common. However, a series of methodological shortcomings may limit the practical application of cost-effectiveness analysis results for deciding to reallocate resources between interventions to achieve social objectives. Two examples of this are methodological differences between studies that limit comparability, and use of the current practice as a comparator, which implicitly assumes current resource use is efficient. Generalized Cost-Effectiveness Analysis (GCEA) was developed to overcome such shortcomings of traditional cost-effectiveness analysis.

The GCEA approach enables both existing and new interventions to be evaluated simultaneously. The comparator used in GCEA is a hypothetical “null” scenario, where the impacts of all currently implemented interventions are removed. Uniquely, this method allows existing and new interventions to be analyzed at the same time. Using GCEA, the analyst is no longer constrained by what is already being done, and policymakers can revisit and revise past choices if necessary and feasible.

WHO-CHOICE

GCEA is part of the WHO-CHOICE project, which reports the costs and effects of a wide range of health interventions in the 14 demographic sub-regions of WHO (world divisions made based on geographical location and demographic profiles). The results of these cost-effectiveness analyses are assembled in sub-regional databases. This project uses a standardized method for cost effectiveness analysis that can be applied to all interventions across health sectors and in different settings.

The tools required to assess intervention costs and impacts at the population level are available for use at country level and the CHOICE team is available to assist policy makers and other stakeholders to interpret and use the evidence.