Toolbox for decrementally cost-effective interventions (d-CEIs) in HTA
This toolbox helps decision-makers assess health interventions that are less effective but also less costly, to determine when they should be adopted. It supports fair and transparent decisions by using tools like a checklist, decision tree, and choice experiments, especially when savings from less costly options can be reinvested to benefit more people.
At a glance
Use when
Evaluating cheaper, less effective interventions where cost savings can be reinvested; supporting policy decisions in resource-constrained settings; conducting ethical deliberations on trade-offs in HTA.
Avoid when
When reinvestment of savings is not feasible or guaranteed; in contexts prioritizing individual-level efficacy above population-level gains; when robust cost and outcome data are unavailable.
Inputs
Data on cost differences and health outcome losses of interventions; stakeholder preferences; context-specific budget and reinvestment assumptions.
Outputs
Structured deliberation outputs guiding adoption decisions; ethical justification for d-CEI use; prioritization recommendations based on cost-effectiveness trade-offs.
How it works
The toolbox provides methodological support for evaluating decrementally cost-effective interventions (d-CEIs)—health technologies that reduce both costs and health outcomes. It includes a discrete choice experiment, a structured checklist, and a decision tree to guide ethical and transparent adoption decisions in HTA. Grounded in evidence from a systematic review identifying 107 such interventions, the toolbox supports policy-level decisions where cost savings from d-CEIs can be reallocated to improve population health. It addresses gaps in traditional HTA frameworks that prioritize more effective but costlier innovations.
- Project
- IMPACT HTA
- Funding
- Horizon 2020
- Project status
- Completed 2021
- HTA domains
- Costs & Economic Evaluation
- Categories
- Decremental CEA
- Technology
- Non-specific
- Assumptions
- Savings from less costly, less effective interventions can be reinvested to generate greater population health gains; small individual efficacy losses are acceptable if overall health system benefits increase.
- Strengths
- Promotes population-level health maximization; supports transparent and ethical decision-making; integrates stakeholder values through choice experiments; addresses a gap in traditional HTA frameworks.
- Limitations
- Requires reliable data on cost and outcome reductions; depends on reinvestment of savings, which may not occur in practice; limited applicability in systems without mechanisms for reallocation.
- Also known as
- d-CEI Toolbox, Toolbox for decrementally cost-effective interventions
Questions this answers
- › When should a less effective but cheaper health intervention be adopted?
- › How can cost savings from less effective treatments be ethically reinvested?
- › What tools help assess trade-offs between lower efficacy and lower cost in healthcare?
- › How can decision-makers ensure transparency when recommending less effective options?
- › What frameworks support the ethical adoption of decrementally cost-effective technologies?
- › How do we balance individual health losses with population-level health gains?
References & sources
- deliverableec.europa.eu ↗
- paperDOI: 10.3389/fphar.2022.1025326 ↗
Similar by meaning
Beta record. Generated from the primary source via AI extraction and independent audit, pending final human review.