Guiding Health Resource Allocation: Using Population Net Health Benefit to Align Disease Burden with Cost Effectiveness for Informed Decision Making

Limited healthcare resources necessitate a strategic approach to their allocation. This paper highlights the importance of population net health benefit (NHB) metric as a means of aligning two existing concepts used for resource prioritization in health: burden of disease and cost effectiveness. By explicitly incorporating health opportunity costs and eligible patient population size, NHB provides a clearer understanding of the likely scale of impact of interventions on population health. Moreover, when expressed in disability-adjusted life years (DALYs) averted, NHB enables policymakers to effectively communicate the population-level health gains from interventions relative to the existing disease burden. Using a stylized example, we demonstrate the estimation of population NHB for four alternative health interventions and its use in resource allocation decisions. The analysis reveals how variations in patient population size and health opportunity costs can significantly impact NHB estimates, ultimately influencing resource allocation decisions. The results further illustrate how NHB can be expressed as a proportion of the total disease burden, allowing for the consideration of the percentage of the overall burden addressed by each intervention. The paper demonstrates how population NHB combines cost effectiveness with components of disease burden, offering a more comprehensive approach to health intervention selection and implementation. As countries move towards universal health coverage, this metric can aid policymakers in making informed, evidence-based decisions.