To sustain positive progress toward sustainable development goals as envisioned in goal 3 and beyond, safe and affordable care during pregnancy and birth for women, their families, and health facilities and professionals is essential. In this systematic review, we report the best available evidence regarding the cost and cost-effectiveness of birth in various settings, including hospitals, birth centres, and homes for women at low risk of complications from high-, middle-, and low-income countries.

Private hospitals account for 46% of all hospitals empanelled in India's national health insurance scheme and contribute to 54% of all the hospitalizations under it. However, insufficient package prices are often cited as a constraint to viable hospital operations. This study assesses the financial viability of establishing such hospitals at district level, with a focus on determining the break-even threshold by forecasting the financial trajectory of hospitals.

Scientific advancements offer significant opportunities for better patient outcomes, but also present new challenges for value assessment, affordability and access. Alternative payment models (APMs) can offer solutions to the ensuing payer challenges. However, a comprehensive framework that matches the spectrum of challenges with the right solution, and places them within a framework for implementation, is currently missing. To fill this gap, we propose evidence-based steps for the effective selection and implementation of APMs. First, contracting challenges should be identified and mapped to potential APM solutions. We developed a decision guide that can serve as a starting point to articulate core problems and map these to APM solutions. The main problem categories identified are: budget impact and uncertainty, value uncertainty, and the scope of value assessment and negotiation. Sub-categories include affordability, uncertainty of effectiveness, and patient heterogeneity, which map onto APM solutions such as outcome-based agreements, instalments, and subscription models. Just as important are the subsequent identification and assessment of the feasibility of potential solutions as well as collaboration to reach agreement on the terms of the APM and lay the groundwork for effective implementation. We adduce recent examples of APM implementation as evidence of how commonly cited implementation barriers can be overcome by applying pragmatic design choices and collaboration. This step-by-step framework can aid payers and manufacturers in the process of effectively identifying, agreeing on, and implementing APMs to advance patient access to cost-effective medicines, while at the same time providing appropriate incentives to support future innovation.

Limited healthcare resources necessitate a strategic approach to their allocation. This paper highlights the importance of population net health benefit (NHB) metric as a means of aligning two existing concepts used for resource prioritization in health: burden of disease and cost effectiveness. By explicitly incorporating health opportunity costs and eligible patient population size, NHB provides a clearer understanding of the likely scale of impact of interventions on population health. Moreover, when expressed in disability-adjusted life years (DALYs) averted, NHB enables policymakers to effectively communicate the population-level health gains from interventions relative to the existing disease burden. Using a stylized example, we demonstrate the estimation of population NHB for four alternative health interventions and its use in resource allocation decisions. The analysis reveals how variations in patient population size and health opportunity costs can significantly impact NHB estimates, ultimately influencing resource allocation decisions. The results further illustrate how NHB can be expressed as a proportion of the total disease burden, allowing for the consideration of the percentage of the overall burden addressed by each intervention. The paper demonstrates how population NHB combines cost effectiveness with components of disease burden, offering a more comprehensive approach to health intervention selection and implementation. As countries move towards universal health coverage, this metric can aid policymakers in making informed, evidence-based decisions.

Economic evaluations through decision-analytical models have played a limited role in shaping healthcare resource optimisation and reimbursement decisions in the Middle East.

GaitSmart (Dynamic Metrics Ltd) is a class I CE-marked sensor-based digital technology designed to measure lower limb movement via sensors placed on the body. GaitSmart aims to identify any problems with gait, and provide a personalised rehabilitation programme via the integrated vGym app. The company identified people referred for knee or hip replacement and people at risk of falling as potentially being able to benefit from GaitSmart. The clinical evidence identified was limited in its applicability to the scope of the assessment, and there was large variability in the comparators used in these studies and in the current care pathways, especially for people at risk of falls. There is some limited evidence that patients like the report generated by the technology and found it helpful in understanding their condition. Clinical experts thought GaitSmart had the potential to improve outcomes for patients and could be used in the community setting by a range of healthcare professionals. Economic modelling over a 1-year time horizon from a UK National Health Service (NHS) perspective for the falls model and a 17-week horizon for the rehabilitation model indicate that GaitSmart is cost saving; however, this is dependent on the model of standard care. Where GaitSmart is delivered by trained healthcare assistants, it would lead to a reduction in staff time costs compared to most alternative standard care options. Uncertainty is greater in the falls model given the high variability in standard care. In April 2024, the National Institute for Health and Care Excellence recommended that GaitSmart can be used to treat gait and mobility issues in adults at risk of falls, while more evidence is gathered. For adults having hip or knee replacements, access to GaitSmart should be via the company, research or non-core NHS funding, with appropriate management of any risks.

No systematic country-level comparison has been undertaken between crosswalk- and EQ-VT-derived EQ-5D-5L value sets. Crosswalk values can differ from EQ-VT-based EQ-5D-5L value sets owing to valuation protocols, changes in societal preferences over time, and a change in the label of the highest level on mobility in moving from EQ-5D-3L to EQ-5D-5L. This study aimed to compare the five-level (5L) crosswalk and EQ-VT value sets to explore differences between them at the country level.

The utility of genome-wide sequencing is often quantified in terms of its diagnostic yield. Although obtaining a diagnosis is a fundamental aspect of value, service users also value broader clinical, informational, process and psychological factors in the provision of genomic testing. This study aims to value genome-wide sequencing from the user perspective in Scotland.

Midwives are essential in achieving universal health coverage targets and the health targets of the Sustainable Development Goals, yet a significant global shortfall exists in the midwifery workforce. Economic evaluations of midwifery are scarce but can assist in supporting evidence-informed decision-making for sustainable and equitable health care for women and girls.

To measure socioeconomic-related inequality in perceived unmet needs for financial reasons for mental health care in Spain and to assess socioeconomic-related inequity in access to mental health professionals and psychotropic drugs.

The growth of scientific literature in health economics and policy represents a challenge for researchers conducting literature reviews. This study explores the adoption of a machine learning (ML) tool to enhance title and abstract screening. By retrospectively assessing its performance against the manual screening of a recent scoping review, we aimed to evaluate its reliability and potential for streamlining future reviews.

Anxiety and depression are prevalent in young people. Web-based mental health interventions (W-MHIs) have the potential to reduce anxiety and depression, yet the level of engagement remains low. This study aims to elicit young people's preferences towards W-MHIs and the relative importance of intervention attributes in influencing choice.

Genomic medicine offers an unprecedented opportunity to improve cancer outcomes through prevention, early detection and precision therapy. Health policy makers worldwide are developing strategies to embed genomic medicine in routine cancer care. Successful translation of genomic medicine, however, remains slow. This systematic review aims to identify and synthesise published evidence on the cost effectiveness of genomic medicine in cancer control. The insights could support efforts to accelerate access to cost-effective applications of human genomics.

As societies emerge from the COVID-19 pandemic, governments are increasingly moving away from a focus on economic growth at any cost towards the principles of a wellbeing economy, focused on achieving a more equitable distribution of wealth and wellbeing. This study aimed to assess the relative importance to the Australian general public of the key principles of a wellbeing economy and to investigate heterogeneity in preferences between demographic subgroups.

Antimicrobial resistance is a global emergency related to overprescribing of antibiotics. Few studies have explored how prescribing behaviours may change as the consequence of changing resistance. Understanding how contextual factors influence antibiotic prescribing will facilitate improved communication strategies to promote appropriate antibiotic prescribing. We aimed to develop and conduct a discrete choice experiment (DCE) to measure how contextual factors influence intended antibiotic prescribing of general practitioner (GP) registrars.

Economic evaluations of obesity interventions are critical to informing policymakers and clinical practitioners about best-value prevention and treatment interventions. However, existing studies often fail to measure appropriate outcomes over sufficient time periods and to adequately address the complexity of data, environments and outcomes. An international, multidisciplinary workshop in Ireland (May 2023) addressed these issues through scientific presentations on obesity modelling, group discussions and interactive small-group exercises. Nineteen presenters and participants co-created a list of research needs, priorities and strategies for the long-term study of obesity and its complications. To support availability of relevant outcome and cost data for health economic analyses, participants highlighted a need to define standards for data collection, data sharing, modelling, and integrating a systems perspective. For example, regarding data collection, careful consideration must be given to selecting valid and relevant health-related outcomes for determining future health risk. Although these issues have been previously highlighted, they remain critical barriers to comprehensive economic obesity studies. To identify best-value obesity interventions, researchers should prioritise strategies to overcome these barriers. This includes early engagement with multidisciplinary stakeholders to integrate diverse perspectives. Developing infrastructure to support international collaborations between researchers, policymakers and patient representatives was also recommended. Additionally, establishing best-practice guidelines could help researchers navigate the complexities of obesity data, environments and outcomes, particularly in data-scarce research environments. The creation of a core outcomes set for obesity would standardise measures for economic evaluations, thereby facilitating more robust cross-country comparisons of intervention effects and improving the evidence base and overall quality of future obesity research.

Sequential next-generation sequencing (NGS) testing has demonstrated cost-effectiveness in guiding targeted therapy with tyrosine kinase inhibitors (TKIs) for advanced non-small cell lung cancer (aNSCLC) in developed countries. However, its cost-effectiveness in developing countries remains uncertain.

The quality-adjusted life year (QALY) is widely used to measure health outcome that combines the length of life and health-related quality of life (HRQoL). To be a reliable QALY measure, HRQoL measurements with a preference-based scoring algorithm need to be converted into health utilities on a scale from zero (dead) to one (perfect health). However, preference-based health utility data are often not available. We address this gap by developing a predictive model for health utilities.

To compare the performance of matching-adjusted indirect comparison (MAIC) and naïve indirect comparison (NIC) under a wide range of data scenarios on survival outcome.