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  1. Book: Global health priority-setting

    Norheim, Ole Frithjof / Emanuel, Ezekiel J. / Millum, Joseph

    beyond cost-effectiveness

    2020  

    Abstract: Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development ...

    Author's details edited by Ole F. Norheim, Ezekiel J. Emanuel, and Joseph Millum
    Abstract Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children's educational attainment, or just focus on health outcomes? Does age matter for priority setting or should it be ignored? Arehealth gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? Global Health Priority-Setting provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policy-makers, and clinicians from around the world assess the state of current practice in national and global priority setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocatinghealth resources.
    Keywords Public health & preventive medicine ; Health systems & services
    Language English
    Size xx, 340 Seiten, Illustrationen
    Publisher Oxford University Press
    Publishing place New York
    Publishing country United States
    Document type Book
    HBZ-ID HT020425692
    ISBN 978-0-19-091276-5 ; 0-19-091276-6
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2020 A 521 available for loan (reading room) Lesesaal EG

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  2. Article ; Online: Accurate fetal diagnostics raise new ethical questions.

    Norheim, Ole Frithjof / Frost, Petter

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2021  Volume 141, Issue 16

    Title translation Treffsikker fosterdiagnostikk gir nye etiske spørsmål.
    MeSH term(s) Ethics, Medical ; Female ; Humans ; Morals ; Pregnancy ; Prenatal Diagnosis
    Language Norwegian
    Publishing date 2021-11-08
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.21.0735
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: Premature Death as a Normative Concept.

    Sørheim, Preben / Barra, Mathias / Norheim, Ole Frithjof / Gamlund, Espen / Solberg, Carl Tollef

    Health care analysis : HCA : journal of health philosophy and policy

    2024  

    Abstract: The practical goal of preventing premature death seems uncontroversial. But the term 'premature death' is vague with several, sometimes conflicting definitions. This ambiguity results in several conceptions with which not all will agree. Moreover, the ... ...

    Abstract The practical goal of preventing premature death seems uncontroversial. But the term 'premature death' is vague with several, sometimes conflicting definitions. This ambiguity results in several conceptions with which not all will agree. Moreover, the normative rationale behind the goal of preventing premature deaths is masked by the operational definition of existing measures. In this article, we argue that 'premature death' should be recognized as a normative concept. We propose that normative theories should be used to justify measures of premature death to provide them with normative validity and public legitimacy.
    Language English
    Publishing date 2024-01-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1160541-8
    ISSN 1573-3394 ; 1065-3058
    ISSN (online) 1573-3394
    ISSN 1065-3058
    DOI 10.1007/s10728-023-00471-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Can Geographically Targeted Vaccinations Be Ethically Justified? The Case of Norway During the COVID-19 Pandemic.

    Amdam, Håkon / Norheim, Ole Frithjof / Solberg, Carl Tollef / Littmann, Jasper R

    Public health ethics

    2023  Volume 16, Issue 2, Page(s) 139–151

    Abstract: This article discusses the fairness of geographically targeted vaccinations (GTVs). During the initial period of local and global vaccine scarcity, health authorities had to enact priority-setting strategies for mass vaccination campaigns against COVID- ... ...

    Abstract This article discusses the fairness of geographically targeted vaccinations (GTVs). During the initial period of local and global vaccine scarcity, health authorities had to enact priority-setting strategies for mass vaccination campaigns against COVID-19. These strategies have in common that priority setting was based on personal characteristics, such as age, health status or profession. However, in 2021, an alternative to this strategy was employed in some countries, particularly Norway. In these countries, vaccine allocation was also based on the epidemiological situations in different regions, and vaccines were assigned based on local incidence rates. The aim of this article is to describe and examine how a geographical allocation mechanism may work by considering Norway as a case study and discuss what ethical issues may arise in this type of priority setting. We explain three core concepts: priority setting, geographical priority setting and GTVs. With a particular focus on Norway, we discuss the potential effects of GTV, the public perception of such a strategy, and if GTV can be considered a fair strategy. We conclude that the most reasonable defence of GTV seems to be through a consequentialist account that values both total health outcomes and more equal outcomes.
    Language English
    Publishing date 2023-07-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2438463-X
    ISSN 1754-9981 ; 1754-9973
    ISSN (online) 1754-9981
    ISSN 1754-9973
    DOI 10.1093/phe/phad011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Appraising Drugs Based on Cost-effectiveness and Severity of Disease in Norwegian Drug Coverage Decisions.

    Tranvåg, Eirik Joakim / Haaland, Øystein Ariansen / Robberstad, Bjarne / Norheim, Ole Frithjof

    JAMA network open

    2022  Volume 5, Issue 6, Page(s) e2219503

    Abstract: Importance: Rising health care costs are a major health policy challenge globally. Norway has implemented a priority-setting system intended to balance cost-effectiveness and concerns for fair distribution, but little is known about this strategy and ... ...

    Abstract Importance: Rising health care costs are a major health policy challenge globally. Norway has implemented a priority-setting system intended to balance cost-effectiveness and concerns for fair distribution, but little is known about this strategy and whether it works in practice.
    Objective: To present and evaluate a systematic drug appraisal method that uses the severity of disease to account for a fair distribution of health in cost-effectiveness analysis, forming the basis for price negotiations and coverage decisions.
    Design, setting, and participants: This cross-sectional study uses confidential drug price information and publicly available data from health technology assessments and logistic and linear regression analyses to evaluate drug coverage decisions for the Norwegian specialized health care sector from 2014 to 2019.
    Main outcomes and measures: Drug coverage decisions by Norwegian authorities and incremental cost-effectiveness and severity of disease measured as absolute shortfall of quality adjusted life years.
    Results: Between 2014 and 2019, a total of 188 drugs were appraised, of which 113 were cancer drugs. The overall coverage rate was 73% (138 of 188). The number of annual appraisals increased during the observation period. Based on 83 chosen decisions, regression analysis showed that incremental cost-effectiveness ratios (ICER) based on negotiated drug prices, adjusted for severity-differentiated cost-effectiveness thresholds, was the variable that best projected drug approvals (OR, 0.60; 95% CI, 0.42-0.86). An increase in the ICER by $10 000 was associated with a reduction in the odds for approval of 40% for drugs assessed from 2018 to 2019.
    Conclusions and relevance: This cross-sectional study demonstrated how concerns for efficiency and fair distribution of health can be implemented systematically into drug appraisals and reimbursement decisions. New, expensive drugs are expected to escalate health care costs in the years to come, and it may be feasible to control costs by negotiating the prices of new drugs while appraising both their cost-effectiveness and how their health benefits are distributed.
    MeSH term(s) Antineoplastic Agents ; Cost-Benefit Analysis ; Cross-Sectional Studies ; Drug Costs ; Humans ; Severity of Illness Index
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2022-06-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.19503
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: The economic costs of orthopaedic services: a health system cost analysis of tertiary hospitals in a low-income country.

    Twea, Pakwanja / Watkins, David / Norheim, Ole Frithjof / Munthali, Boston / Young, Sven / Chiwaula, Levison / Manthalu, Gerald / Nkhoma, Dominic / Hangoma, Peter

    Health economics review

    2024  Volume 14, Issue 1, Page(s) 13

    Abstract: Background: Traumatic injuries are rising globally, disproportionately affecting low- and middle-income countries, constituting 88% of the burden of surgically treatable conditions. While contributing to the highest burden, LMICs also have the least ... ...

    Abstract Background: Traumatic injuries are rising globally, disproportionately affecting low- and middle-income countries, constituting 88% of the burden of surgically treatable conditions. While contributing to the highest burden, LMICs also have the least availability of resources to address this growing burden effectively. Studies on the cost-of-service provision in these settings have concentrated on the most common traumatic injuries, leaving an evidence gap on other traumatic injuries. This study aimed to address the gap in understanding the cost of orthopaedic services in low-income settings by conducting a comprehensive costing analysis in two tertiary-level hospitals in Malawi.
    Methods: We used a mixed costing methodology, utilising both Top-Down and Time-Driven Activity-Based Costing approaches. Data on resource utilisation, personnel costs, medicines, supplies, capital costs, laboratory costs, radiology service costs, and overhead costs were collected for one year, from July 2021 to June 2022. We conducted a retrospective review of all the available patient files for the period under review. Assumptions on the intensity of service use were based on utilisation patterns observed in patient records. All costs were expressed in 2021 United States Dollars.
    Results: We conducted a review of 2,372 patient files, 72% of which were male. The median length of stay for all patients was 9.5 days (8-11). The mean weighted cost of treatment across the entire pathway varied, ranging from $195 ($136-$235) for Supracondylar Fractures to $711 ($389-$931) for Proximal Ulna Fractures. The main cost components were personnel (30%) and medicines and supplies (23%). Within diagnosis-specific costs, the length of stay was the most significant cost driver, contributing to the substantial disparity in treatment costs between the two hospitals.
    Conclusion: This study underscores the critical role of orthopaedic care in LMICs and the need for context-specific cost data. It highlights the variation in cost drivers and resource utilisation patterns between hospitals, emphasising the importance of tailored healthcare planning and resource allocation approaches. Understanding the costs of surgical interventions in LMICs can inform policy decisions and improve access to essential orthopaedic services, potentially reducing the disease burden associated with trauma-related injuries. We recommend that future studies focus on evaluating the cost-effectiveness of orthopaedic interventions, particularly those that have not been analysed within the existing literature.
    Language English
    Publishing date 2024-02-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2634483-X
    ISSN 2191-1991
    ISSN 2191-1991
    DOI 10.1186/s13561-024-00485-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage.

    Norheim, Ole Frithjof

    International journal of health policy and management

    2015  Volume 4, Issue 11, Page(s) 711–714

    Abstract: This article discusses what ethicists have called "unacceptable trade-offs" in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. But some trade-offs are unacceptable on ... ...

    Abstract This article discusses what ethicists have called "unacceptable trade-offs" in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. But some trade-offs are unacceptable on the path to universal coverage. Unacceptable choices include, among other examples from low-income countries, to expand coverage for services with lower priority such as coronary bypass surgery before securing universal coverage for high-priority services such as skilled birth attendance and services for easily preventable or treatable fatal childhood diseases. Services of the latter kind include oral rehydration therapy for children with diarrhea and antibiotics for children with pneumonia. The article explains why such trade-offs are unfair and unacceptable even if political considerations may push in the opposite direction.
    MeSH term(s) Child ; Developing Countries ; Health Care Rationing ; Health Equity ; Health Policy ; Health Priorities ; Humans ; Income ; Morals ; Universal Health Insurance/ethics
    Language English
    Publishing date 2015-10-11
    Publishing country Iran
    Document type Editorial
    ZDB-ID 2724317-5
    ISSN 2322-5939 ; 2322-5939
    ISSN (online) 2322-5939
    ISSN 2322-5939
    DOI 10.15171/ijhpm.2015.184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Cost-Effectiveness of Saxagliptin Compared With Glibenclamide as a Second-Line Therapy Added to Metformin for Type 2 Diabetes Mellitus in Ethiopia.

    Bekele, Mengistu / Norheim, Ole Frithjof / Hailu, Alemayehu

    MDM policy & practice

    2021  Volume 6, Issue 1, Page(s) 23814683211005771

    Abstract: Background. ...

    Abstract Background.
    Language English
    Publishing date 2021-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2861432-X
    ISSN 2381-4683 ; 2381-4683
    ISSN (online) 2381-4683
    ISSN 2381-4683
    DOI 10.1177/23814683211005771
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: New strides towards fair processes for financing universal health coverage.

    Kurowski, Christoph / Evans, David B / Ottersen, Trygve / Gopinathan, Unni / Dale, Elina / Norheim, Ole Frithjof

    Health policy and planning

    2023  Volume 38, Issue Supplement_1, Page(s) i5–i8

    MeSH term(s) Humans ; Universal Health Insurance ; Health Care Reform ; Health Expenditures ; Healthcare Financing
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 632896-9
    ISSN 1460-2237 ; 0268-1080
    ISSN (online) 1460-2237
    ISSN 0268-1080
    DOI 10.1093/heapol/czad065
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    In stock of ZB MED Cologne/Königswinter

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  10. Article: A grand convergence in mortality is possible: comment on Global Health 2035.

    Norheim, Ole Frithjof

    International journal of health policy and management

    2014  Volume 2, Issue 1, Page(s) 1–3

    Abstract: The grand challenge in global health is the inequality in mortality and life expectancy between countries and within countries. According to Global Health 2035, the Lancet Commission celebrating the 20(th) anniversary of the World Development Report (WDR) ...

    Abstract The grand challenge in global health is the inequality in mortality and life expectancy between countries and within countries. According to Global Health 2035, the Lancet Commission celebrating the 20(th) anniversary of the World Development Report (WDR) of 1993, the world now has the unique opportunity to achieve a grand convergence in global mortality within a generation. This article comments on the main findings and recommendations of the Global Health 2035.
    Language English
    Publishing date 2014-01-09
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2724317-5
    ISSN 2322-5939
    ISSN 2322-5939
    DOI 10.15171/ijhpm.2014.01
    Database MEDical Literature Analysis and Retrieval System OnLINE

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