The Question

Universal public finance (UPF) for health interventions entail consequences in a number of domains. UPF increases intervention uptake and consequent health gains; generates financial consequences; and provides insurance either through coverage or prevention. How can the consequences of UPF in each of these domains be evaluated? How can this be applied to UPF for tuberculosis treatment in India?

What we found

We developed a method for the economic evaluation of UPF and other health policy instruments, which we call “extended cost-effectiveness analysis” (ECEAs).When applied to evaluating UPF in TB treatment in India, our ECEA example concluded that replacing private finance for TB treatment with UPF could bring substantial health gains and financial risk protection benefits. These benefits would have the most effect on poorer populations.

Why it matters

ECEA builds on standard cost-effectiveness analysis (CEA) in three dimensions, all of which enhance the ability of stakeholders to evaluate policy: first, some health policy instruments (in particular UPF) will provide insurance against financial risks; second, policies have direct financial implications because private expenditures may be crowded out; last, health policy instruments have distributional consequences across wealth strata of a population. The methods we developed and employed in this study can therefore be a useful application in further analyzing health policy across a wide range of policy instruments and places.

Homepage image via Yale Rosen/Flickr.