When low benefit-cost ratios mean we need to invest more, not less: The social determinants of value in health

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.