Costing Health Benefit Packages Using the WHO UHC Compendium: A Proof-of-Concept Study in Kyrgyzstan

Background: Many countries are defining health benefits packages to progress toward universal health coverage (UHC). Cost estimates are required to ensure packages are affordable and implementable. However, a gap persists between global costing tools and recommendations informing package design and the way services are defined for country-level implementation. To address this, we developed the first health systems-wide costing tool and approach based on the World Health Organization (WHO) UHC Compendium database, which provides structured service definitions and data to facilitate country-level contextualisation and implementation. This paper presents our tool and approach through a proof-of-concept study in Kyrgyzstan. Methods: We developed a tool in Microsoft Excel that estimates normative economic costs for over 500 UHC Compendium services using a combination of bottom-up and top-down approaches. Resource use was derived from UHC Compendium metadata, supplemented with publicly available and country-specific data sources to inform input prices and population in need estimates. In Kyrgyzstan, all secondary data were validated and contextualised with national experts. We produced high-level cost estimates for 424 services identified as relevant for Kyrgyzstan and refined estimates for 181 priority services selected by country stakeholders. Sensitivity analyses investigated variations in personnel, medicine and overhead costs and currency fluctuations. Results: Delivering all 424 services at current utilisation levels, or low levels of utilisation for services not yet implemented, would cost an estimated US$ 186.97 per capita annually. Providing the 181 priority services would cost US$ 74.41 per capita at current utilisation levels and US$ 189.44 per capita if scaled to full (100%) utilisation. Costs were driven primarily by personnel and medicines. Sensitivity analyses showed costs ranging from US$ 58.76 to 90.05 per capita. Conclusion: This study demonstrates the feasibility of using UHC Compendium data to generate country-specific, service-level cost estimates for benefits package design. Other countries can adapt our tool and approach to design affordable and implementable packages in support of UHC goals.