Reading list

Back to the workshop

Every citation below has been checked against PubMed: authors, journal, year, volume, pages and PMID. Where a slide or widget uses a constructed example it says so on the slide, and those are not listed here.

Core text

Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. 4th ed. Oxford: Oxford University Press; 2015.

• Ch. 1 Introduction to Economic Evaluation (pp. 1–19) → Session 2
• Ch. 2 Making Decisions in Health Care (pp. 19–41) → Session 6
• Ch. 4 Principles of Economic Evaluation (pp. 77–123) → Sessions 3, 5 and 8

The 4th edition renumbers chapters relative to the 3rd. If you are reading a 3rd-edition copy, the Chapter 4 material sits mostly in its chapters 3 and 4.

Session 2 — What economic evaluation is

The policy decision we open with

• Press Information Bureau, Government of India. Cervical Cancer Vaccination Campaign launched. 28 February 2026 (PRID 2234009). Single-dose quadrivalent HPV vaccine for girls aged 14, about 1.15 crore girls a year, free at government facilities, introduced into the national routine immunisation schedule with GAVI support. Burden figures cited from GLOBOCAN 2022: over 120,000 new cervical cancer cases and about 80,000 deaths a year in India, roughly 25% of global cervical cancer deaths.

One disease, six study designs

The four types of full economic evaluation

• CMA   Minakaran N, Morjaria P, Frick KD, Gilbert C. Cost-minimisation analysis from a non-inferiority trial of ready-made versus custom-made spectacles for school children in India. Ophthalmic Epidemiol 2021;28(5):383–91. PMID 33256485
• CEA   Esposito DH, Tate JE, Kang G, Parashar UD. Projected impact and cost-effectiveness of a rotavirus vaccination program in India, 2008. Clin Infect Dis 2011;52(2):171–7. PMID 21288839
• CUA   Chauhan 2020 (above), and Gupta N, Verma RK, Gupta S, Prinja S. Cost effectiveness of trastuzumab for management of breast cancer in India. JCO Glob Oncol 2020;6:205–16. PMID 32045547
• CBA   Rare in health. See Drummond ch. 1, and the CBA chapter of the 4th edition, for why.

Quality of the Indian evidence base

• Prinja S, Chauhan AS, Angell B, et al. A systematic review of the state of economic evaluation for health care in India. Appl Health Econ Health Policy 2015;13(6):595–613. PMID 26449485

Session 6 — Thresholds, opportunity cost and budget impact

Where the threshold comes from

• Chugh Y, Jyani G, Kar SS, Patro BK, Trivedi M, Albert S, Raman S, Rajsekar K, Prinja S; India cost-effectiveness threshold (CET) estimation study group. Estimating the willingness-to-pay per quality-adjusted life-year to aid health technology assessment in India. Value Health 2026;29(3):457–66. PMID 41176029 India's first empirical WTP per QALY. 5,460 respondents across six states, 21,640 observations, 12 hypothetical health states, time trade-off plus willingness to pay, gains discounted at 3%. Mean weighted ₹2,12,307 (US$2,535); range across health states ₹1,70,414 to ₹2,58,985; equivalent to 1.0 to 1.52 times GDP per capita. Read the limitations section, because this is a demand-side estimate.
• Woods B, Revill P, Sculpher M, Claxton K. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value Health 2016;19(8):929–35. PMID 27987642 The supply-side counterpart. Opportunity-cost-based thresholds of 1 to 51% of GDP per capita for the countries modelled. Conclusion: routinely used thresholds have been too high.
• Bertram MY, Lauer JA, De Joncheere K, Edejer T, et al. Cost-effectiveness thresholds: pros and cons. Bull World Health Organ 2016;94(12):925–30. PMID 27994285 WHO-affiliated authors on why the 1 to 3 times GDP per capita rule should not be used as a decision rule.
• Marseille E, Larson B, Kazi DS, Kahn JG. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ 2015;93(2):118–24. PMID 25883405

League tables

• Shah K, Singh M, Kotwani P, Tyagi K, Pandya A, Saha S, Saxena D, Rajshekar K. Comprehensive league table of cost-utility ratios: a systematic review of cost-effectiveness evidence for health policy decisions in India. Front Public Health 2022;10:831254. PMID 36311623 79 studies, 2003 to 2019. 70% reported DALYs and 30% QALYs; 73% discounted at 3%, 4% at 5%, and 23% did not discount at all; sensitivity analysis in 73%, budget impact in only 18%. Read it for the methodological heterogeneity as much as for the table.

A published threshold, and what happens when it moves

• NICE. Changes to NICE's cost-effectiveness thresholds confirmed. 1 December 2025. nice.org.uk £20,000 to £30,000 per QALY becomes £25,000 to £35,000 from April 2026. NICE estimates 3 to 5 additional medicines or indications a year. A new EQ-5D-5L value set was announced alongside.
• Vallejo-Torres L, Edney LC, Espinosa O, Karnon J, Longo F. Politicised changes to the NICE threshold risk making cost-effectiveness analysis performative, not informative. Appl Health Econ Health Policy 2026;24(2):243–6. PMID 41513890 Short, sharp, and the best thing to hand anyone who thinks thresholds are a technical matter.

HTAIn

• HTAIn, Department of Health Research, Ministry of Health and Family Welfare. htain.icmr.org.in HTAIn is an attached office of the Department of Health Research. Governance (Board, Technical Appraisal Committee, Secretariat, Regional Resource Centres) and the topic-to-recommendation process. The Resource Centre network has grown steadily, so check the site for the current list rather than quoting a number.
• Neethi Mohan V, Muraleedharan VR, Subramanian R. Insights and implications: an analysis of the studies undertaken by Health Technology Assessment in India (HTAIn). Health Res Policy Syst 2025;24(1):2. PMID 41316276 Background reading, not taught from a slide. 33 published HTAIn studies rated against Drummond's checklist and the Indian Reference Case; equity and heterogeneity fared worst. Recommends a formal topic-selection framework and identifying areas for disinvestment. The analysis covers studies published up to its own cut-off and HTAIn output has grown well beyond that since, so read the proportions as a snapshot rather than a current description.
• Sharma D, Prinja S, Aggarwal AK, Rajsekar K, Bahuguna P. Development of the Indian Reference Case for undertaking economic evaluation for health technology assessment. Lancet Reg Health Southeast Asia 2023;16:100241. PMID 37694178

Analysis is not the decision

• Dixit J, Prinja S, Jyani G, et al. Evaluating efficiency and equity of prevention and control strategies for rheumatic fever and rheumatic heart disease in India: an extended cost-effectiveness analysis. Lancet Glob Health 2023;11(3):e445–55. PMID 36796988
• Arora S, Tuffaha H. Cost-effectiveness analysis of human papillomavirus vaccines for the prevention of cervical cancer in India. Asia Pac J Clin Oncol 2024;20(1):55–62. PMID 37132538 Cost per DALY averted, healthcare perspective: nonavalent US$362.78, quadrivalent US$393.16, bivalent US$432.24. The nonavalent dominated the others assuming a constant price per dose, an assumption doing a great deal of work. India launched with the quadrivalent.

Sessions 3, 5 and 8 — Framing, outcomes, and handling uncertainty

The spine

• Sharma D, Prinja S, Aggarwal AK, Rajsekar K, Bahuguna P. Development of the Indian Reference Case for undertaking economic evaluation for health technology assessment. Lancet Reg Health Southeast Asia 2023;16:100241. PMID 37694178 Twelve recommendations on eleven principles. Open access, and the recommendation boxes are short and unusually clear. Summarised as a one-page form in the appraisal checklist.

Measuring outcomes

• Jyani G, Sharma A, Prinja S, Kar SS, et al. Development of an EQ-5D value set for India using an extended design (DEVINE) study: the Indian 5-level version EQ-5D value set. Value Health 2022;25(7):1218–26. PMID 35779943 India's own EQ-5D-5L tariff. Applying a UK value set to Indian patients is now an avoidable flaw.
• Jyani G, Yang Z, Sharma A, Goyal A, et al. Evaluation of EQ-VT designs to generate national value sets: learnings from the DEVINE study. Med Decis Making 2023;43(6):692–703. PMID 37480281 Methods companion, for anyone doing valuation work.

Costing in India

• National Health System Cost Database for India (NHSCD). healtheconomics.pgisph.in/costing_web Check here before planning primary data collection.
• Prinja S, Chauhan AS, Bahuguna P, et al. Cost of delivering secondary healthcare through the public sector in India. Pharmacoecon Open 2020;4(2):249–61. PMID 31468323
• Prinja S, Gupta A, Verma R, Bahuguna P, et al. Cost of delivering health care services in public sector primary and community health centres in North India. PLoS One 2016;11(8):e0160986. PMID 27536781
• Singh MP, Prinja S, Rajsekar K, et al. Cost of surgical care at public sector district hospitals in India. Pharmacoecon Open 2022;6(5):745–56. PMID 35733075

Worked examples used in the slides

• Chauhan AS, Prinja S, Srinivasan R, et al. Cost effectiveness of strategies for cervical cancer prevention in India. PLoS One 2020;15(9):e0238291. PMID 32870941 Markov model, societal perspective, lifetime horizon, primary Indian cost and quality-of-life data. The best single methods read in this list.
• Gupta N, Verma RK, Gupta S, Prinja S. Cost effectiveness of trastuzumab for management of breast cancer in India. JCO Glob Oncol 2020;6:205–16. PMID 32045547 The uncertainty example. 1.29 QALYs at ₹1,78,877 per QALY with a 4% probability of being cost-effective using HERA estimates; 1.69 QALYs at ₹1,34,413 with 57.3% using the joint NSABP/NCCTG analysis; 90% with a 15 to 35% price cut.
• Esposito DH, Tate JE, Kang G, Parashar UD. Projected impact and cost-effectiveness of a rotavirus vaccination program in India, 2008. Clin Infect Dis 2011;52(2):171–7. PMID 21288839 One-way sensitivity analysis in which vaccine price and efficacy against severe disease dominated everything else.
• Chugh Y, Dhiman RK, Premkumar M, Prinja S, et al. Real-world cost-effectiveness of pan-genotypic sofosbuvir–velpatasvir versus genotype-dependent regimens for hepatitis C in Punjab's universal coverage scheme. PLoS One 2019;14(8):e0221769. PMID 31465503 A well-conducted state-level Indian cost-utility analysis, useful as a second appraisal paper.

If you read only three things

1. Drummond ch. 1. Nineteen pages, and it settles the classification question for good.
2. Sharma 2023, the Indian Reference Case. The standard your own work will be judged against, and short.
3. Gupta 2020, trastuzumab. The clearest demonstration in the Indian literature of why a point-estimate ICER is not enough.

And if you read a fourth: Chauhan 2020 in PLoS One, an Indian cost-utility analysis, well conducted, on a decision that was actually taken. Read the methods, not just the abstract.