Figure 1

Simplified economic evaluation schema with the application of equity weights. The basic economic evaluation framework (shaded) involves selection of interventions or programs to evaluate, followed by determination of their incremental costs (in monetary units) and outcomes or benefits (often using health state measures such as the QALY) compared to current practice. From this data, the incremental cost-effectiveness ratio (ICER) can be calculated as the net cost per unit of benefit, and the results then compared with the ICERs of other interventions for use in resource allocation and decision-making. Equity weights can be applied to the analyses of selected target populations who are deemed to be worse off. Conventional outcomes-based equity weights apply a weight to the benefits of the intervention, by weighting up the QALYs attributed to disadvantaged groups. The proposed alternative is to apply a cost-side weight to the costs of the intervention, based on equitable processes of health service delivery.