Table 2.

A summary of how the different types of analyses consider the efficiency of resource allocation and examples of their use.

	Cost-effectiveness analyses	Cost-utility analyses	Cost-benefit analyses
How they consider the efficiency of resource allocation	Cost-effectiveness analyses using disease or programme specific metrics are often only concerned with how to use healthcare resources in a way that maximises their output for the cost. As such they are considering technical efficiency, identifying the option that provides the maximal health care for a given cost, or delivering a certain service at a minimal cost.1	Cost-utility analyses can consider the optimal allocation of healthcare resources (such as the mix of interventions) in a way that results in the maximum health gain for a given level of expenditure. In this way, it considers allocative efficiency within the health sector (i.e., it only deals with quasi-allocative assessments) (16).	Cost-benefit analyses can be used to consider the optimal allocation of resources in its broadest sense because once the benefits have been converted into monetary terms then the net economic benefit of different activities can be compared (including to those outside of the healthcare sector). It can therefore consider allocative efficiency across different sectors/across society.
Examples of when it is useful	Useful when a stakeholder is interested in a particular output metric and/or when you do not need to compare the outcome to other interventions/policy options.For example, comparing a range of different malaria interventions when investigating the cost per case averted.	Useful for informing health policy decisions when directly comparing different health interventions that fall within the same budget or benefit package (such as when considering the optimal allocation of a health care budget).For example, deciding if a new vaccine or treatment should be adopted within a national health benefit package.	Useful for cross-sectoral comparisons, such as looking at if other government spending should be reallocated to the healthcare sector (17, 18). Also useful when evaluating health policy/interventions where the health outcome metrics are not suitable (e.g., prenatal genetic screening for Down's syndrome (19)), and in certain complex intervention contexts (such as interlinked packages of care, where maximising health is not the only objective). For example, for considering non-pharmaceutical interventions for COVID-19 control in terms of both health and non-health outcomes.

Note that cost-effectiveness analyses can be used to assess allocative efficiency within and potentially beyond the health sector for life-saving interventions when the outcomes are measured in terms of deaths averted or life-years gained, etc. (16).