Some of these DCP cost-effectiveness estimates are terribly low: few dollars per QALY, compared to GiveWell’s evaluation of their top charities (on the order of $100/QALY).
Even more surprisingly, looking into DCP3, the top 4 interventions had negative cost-effectiveness values.
This seems to me to be mostly because these cost-effectiveness analyses are from a decision-maker standpoint. Say, a hospital that can choose between different medications (e.g. for malaria, $4/DALY) or a governmental policy that can reduce overall health costs (e.g. reducing salt intake, reduction of $1.4k per DALY).
I think it’s mostly because these estimates aren’t properly adjusted for regression to the mean – there’s a ton of sources of model error, and properly factoring these in will greatly reduce the top interventions. There are also other factors like the top interventions quickly running out of capacity. I discuss this in the article. I put a lot more trust in GiveWell’s figures as an estimate of the real marginal cost-effectiveness. Though I agree there could be some interventions accessible to policy-makers that aren’t accessible to GiveWell.
Some of these DCP cost-effectiveness estimates are terribly low: few dollars per QALY, compared to GiveWell’s evaluation of their top charities (on the order of $100/QALY).
Even more surprisingly, looking into DCP3, the top 4 interventions had negative cost-effectiveness values.
This seems to me to be mostly because these cost-effectiveness analyses are from a decision-maker standpoint. Say, a hospital that can choose between different medications (e.g. for malaria, $4/DALY) or a governmental policy that can reduce overall health costs (e.g. reducing salt intake, reduction of $1.4k per DALY).
I think it’s mostly because these estimates aren’t properly adjusted for regression to the mean – there’s a ton of sources of model error, and properly factoring these in will greatly reduce the top interventions. There are also other factors like the top interventions quickly running out of capacity. I discuss this in the article. I put a lot more trust in GiveWell’s figures as an estimate of the real marginal cost-effectiveness. Though I agree there could be some interventions accessible to policy-makers that aren’t accessible to GiveWell.
Yea, I agree with your analyses in the article, though I’d be interested in understanding the relative effects