Abstract Malaria imposes societal costs beyond health, including substantial effects on education, yet economic evaluations often overlook these broader impacts. We conducted a cross-sectoral benefit–cost analysis (BCA) of malaria chemoprevention in school-aged children (SAC) across ten high-burden sub-Saharan African countries. Using recent trial data, we estimated impacts on malaria morbidity, mortality, school absenteeism and literacy. The intervention was projected to cost $422 million and generate $5.7 billion in societal net benefits, yielding a benefit–cost ratio (BCR) of 14.3. Country-level BCRs ranged from 3.71 to 39.5, with the highest returns in Nigeria. Results were sensitive to drug choice, discount rate and valuation of education benefits. When using school quality metrics (estimated via learning-adjusted years of schooling (LAYS)), BCRs increased up to 100-fold compared to estimates based on school quantity alone. Probabilistic sensitivity analysis yielded a mean simulated BCR of 11.00 (95 per cent confidence interval (95% CI): 10.89–11.11), with a >95% probability of being cost-beneficial at a BCR threshold of 3. This study advances the evidence base for malaria chemoprevention in SAC, highlighting its dual health and educational benefits. These findings offer policymakers and funders strong evidence to prioritize malaria chemoprevention in SAC as a high-value investment in both health and human capital in malaria-endemic regions.
Abstract Utility weighting in benefit–cost analysis (sometimes misleadingly referred to using the more general term “distributional weighting”) has, in almost all cases to date, been conducted with data on income ―and on costs and benefits― in income bins or at the geographic unit level, with weights computed at the bin midpoints or average income in a geographic unit. These methods have several shortcomings that cause bias: not accounting for taxes and transfers, not accounting for household composition, incorrect computation of weights, and not accounting for increasing or decreasing distribution of income or impact within bins. These shortcomings are addressed by using a recently developed method using microdata, which also allows for a wider range of applications. I apply this method to real world utility-weighting.
Abstract Small- and medium-sized enterprises incur disproportionately high compliance costs under the traditional goods and services tax/harmonized sales tax (GST/HST) reporting system. To reduce these costs, some EU and Latin American countries have successfully adopted prefilled tax return systems supported by national e-invoicing infrastructures. Canada has not yet adopted this innovation. This study estimates the economic welfare improvement that would result if Canada were to implement a system of prefilled GST/HST returns. An integrated financial, economic and stakeholder cost–benefit analysis is used. Implementation of a prefilled GST/HST return system in Canada is estimated to generate a present value of compliance cost savings over 10 years for GST-/HST-registered businesses of CAD 14.3 billion. Over 99 % of these savings would accrue to over 3.7 million medium, small and self-employed businesses. After netting out the costs of implementing this intervention, the economic welfare improvement for the economy would be CAD 13.6 billion. The additional income taxes collected due to the reduction in business costs have a positive budgetary impact on both the federal and provincial governments. Hence, after deducting estimated costs, the government’s net gain would be CAD 2.6 billion. The net after-tax gain by Canadian businesses would be approximately CAD 11 billion.
Dr. John Morrall was a pioneer in the development of league tables that rank the cost-effectiveness of lifesaving federal regulations. Using Dr. Morrall's methods, we developed a lifesaving league table for 2009-2024 and compared it to Dr. Morrall's largest league table, which covered 1967-2001. Although the sample sizes in the two periods are relatively small and, therefore, limit statistically robust comparisons, we report suggestive evidence that the cost-effectiveness of federal lifesaving regulations has improved. The recent data reinforce Morrall's observation that safety regulations tend to be more cost-effective than health regulations. We also verify a concern of some early critics of lifesaving league tables: as more of the non-lifesaving benefits of federal regulations are included in the ratios, the estimated cost-effectiveness improves. Finally, we describe some practical limitations of using benefit-cost analysis to achieve greater public protections at less cost and recommend that selection of regulatory alternatives be given more emphasis in the conduct of regulatory impact analysis.
Abstract This article quantifies the economic benefits of an influential early childhood program in a developing country, tracking participants with outcomes measured through age 31 years. Drawing on published experimental data encompassing life-cycle benefits – that rely primarily on available labor-market outcomes – alongside a rigorous cost analysis, we estimate an internal rate of return (IRR) of 10.4–10.7% and benefit–cost ratio of ~8. Even though estimates are not that precise, a variety of sensitivity analyses confirm the robustness of these findings. Notably, we find meaningful gender heterogeneity in returns: females exhibit a higher IRR of 11.5%, compared to their male counterparts (9.6%), suggesting that – in developing countries – early childhood programs may generate disproportionately larger economic gains for women.
