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April 13, 2026Health Policy0 citationsOpen Access

When low benefit-cost ratios mean we need to invest more, not less: The Social Determinants of Value in Health

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CDChris P. DesmondKWKathryn WattDSDhyan Saravanja

Key Points

  • The aim is to explore how low benefit-cost ratios in health evaluations reflect structural barriers rather than weak interventions.
  • Analysis of economic evaluations including Benefit-Cost Analysis (BCA)
  • Identifying structural barriers affecting health outcomes
  • Discussion on prioritizing investments based on context
  • Low benefit-cost ratios often indicate structural barriers, not ineffective interventions.
  • Higher investments are recommended in adverse contexts to address these barriers.

Abstract

Economic evaluations such as Benefit-Cost Analysis (BCA) are often used to guide priority setting. However, in adverse contexts, low benefit-cost ratios (BCR) are often not evidence of weak interventions, but reflections of structural barriers. We should therefore invest more in these cases, to tackle these barriers, rather than less.

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Cite This Study

Desmond et al. (2026) studied this question.

synapsesocial.com/papers/69dc88b93afacbeac03ea81chttps://doi.org/10.1016/j.healthpol.2026.105635
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