This is an online course focusing on methods for analysing equity in the distribution of health programme costs and effects and trade-offs between equity and cost-effectiveness. The course is aimed at health economists and health professionals with experience of health economic evaluation, who wish to learn how to use more specialised methods for analysing distributional equity impacts and trade-offs. It is designed for participants who are familiar with standard methods of cost-effectiveness analysis, for example those who have already attended our short courses in Decision Modelling for Health Economic Evaluation. It is envisaged that participants will currently be undertaking cost-effectiveness analysis, or planning to do so in the near future.

By popular demand, in 2024 there are two ways in which students can take this course:

  1. By attending the “live” course scheduled for 21 October to 21 November 2024. Materials are released once per week and students complete the lectures and exercises on the course platform in their own time, then attend a weekly live Q&A session with tutors and faculty via Zoom and can interact with other students, tutors and faculty via online discussion boards. Click below to see the timetable and pre-register.

  2. By following the course “on demand”, which is available immediately. The content is the same as for the live course, but the course is in an unsupported “self-study” format with no tutor and faculty support or interaction with other students, and is aimed at those that wish to start straight away, are unable to make the live course dates, or are in a time zone that makes participating in live sessions difficult. Students gain 2 months’ access from the point of enrolment and work through the content in their own time.  Click below to find out more and sign up.

Option 1

Distributional Cost-Effectiveness Analysis Online Course Live 2024

A timetabled online course comprising five modules over five weeks focusing on methods for analysing the equity impacts of health programmes and trade-offs with cost-effectiveness.
DCEA Course Logo

Option 2

Distributional Cost-Effectiveness Analysis Online Course On Demand

An on demand online course comprising five modules focusing on methods for analysing the equity impacts of health programmes and trade-offs with cost-effectiveness.
DCEA Course Logo


By the end of the course, participants will be able to:

  • Understand and explain the basic concepts of distributional cost-effectiveness analysis (DCEA)

  • Design a full or simplified DCEA study that provides useful information about the direction and magnitude of health equity impact in a specific decision-making context

  • Estimate distributions of health effects and health opportunity costs by adapting a standard cost-effectiveness model – either themselves or in collaboration with others

  • Calculate suitable summary measures of health inequality impact

  • Analyse trade-offs between reducing health inequality and cost-effectiveness

  • Communicate DCEA findings clearly, by producing suitably designed figures and tables and explaining to decision makers what they mean


This is a technical course for analysts, focusing specifically on the design, conduct and reporting of distributional cost-effectiveness analysis studies capable of providing decision makers with useful quantitative information about health equity impacts and trade-offs. Participants would be expected to have attended a general advanced course in health economic evaluation, and to be familiar with foundations level decision analysis (see Foundations Online Course in Decision Analytic Modelling for Health Economic Evaluation). Modules 2, 3 and 4 will involve computer work on exercises which will be built up over the course. Familiarity with Microsoft Excel is essential, and familiarity with algebra is desirable.
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Richard Cookson

Course Lead

Richard is Professor and Co-Director of the Equity in Health Policy Group at the Centre for Health Economics, University of York. He lead edited the course handbook and has helped pioneer “equity-informative” methods of policy analysis, including distributional cost-effectiveness analysis; health equity indicators for healthcare quality assurance; and methods for investigating public concern for reducing health inequality; and is currently developing microsimulation methods for long-term childhood policy analysis.  He has co-chaired international working groups on equity, worked in the UK Prime Minister’s Delivery Unit and served on various NHS advisory committees including the National Institute for Health and Care Excellence and the NHS Advisory Committee on Resource Allocation.

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Susan Griffin

Course Co-Lead

Susan is a Professor of Health Economics at the Centre for Health Economics, University of York. She edited the course handbook and works in the fields of economic evaluation and health technology assessment where her research interests include decision-analytic models, value of information analysis and the incorporation of inequality concerns into cost effectiveness analysis.  Susan has contributed to technology appraisals for NICE, as a member of one of the independent academic groups undertaking evidence reviews, as a member of the Technology Appraisal Committee, and in the development of methods used at NICE.

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Ole Norheim

Course Co-Lead

Ole is Professor and Director of the Bergen Centre for Ethics and Priority Setting (BCEPS) at the Department of Global Public Health and Primary Care, University of Bergen, and Adjunct Professor of Global Health and Population at Harvard University.  He co-edited the course handbook and lead authored a chapter and exercise on analysing equity-efficiency trade-offs.  He formerly chaired the Norwegian National Committee on Priority Setting in Health Care (2013-2014), WHO’s Consultative Group on Equity and Universal Health Coverage (2012-2014) and WHO’s Technical Advisory Group on Health Benefit Packages (2019-21).  His research interests include theories of distributive justice, inequality in health, priority setting in health systems, and how to achieve Universal Health Coverage and the Sustainable Development Goal for health, and his BCEPs team carries out research and capacity building in Norway, Ethiopia, Malawi, India, Tanzania, Ghana, Nepal, and the US.

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James Love-Koh

Course Co-Lead

James is Scientific Adviser at NICE and Honorary Research Fellow at the Centre for Health Economics, University of York. He co-authored the course handbook, as lead author of the chapters and exercises on social distributions of baseline health and health opportunity costs. His research interests are in health equity and decision analytic modelling.  His PhD was on incorporating health inequality concerns into cost-effectiveness analysis, and he subsequently worked at a health economics consultancy, developing decision models and researching public health evaluation and precision medicine, and then at the Centre for Health Economics in the Economic Evaluation and Global Health teams.

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Naomi Gibbs

Tutor Lead

Naomi joined the Centre for Health Economics Team for Economic Evaluation and Health Technology Assessment in January 2022, following completion of her PhD in Public Health and Economic Decision Science with the University of Sheffield.  She is particularly interested in economic methods which support decision makers' concern for equity and is lead convenor of the Equity-Informative Economic Evaluation Special Interest Group, part of the international Health Economics Association (iHEA).  Naomi's PhD focussed on decision modelling to appraise cost and health outcomes of a hypothetical minimum unit pricing policy for alcohol in South Africa. Her work focused on differential policy impact by equity relevant subgroups and included considerable local stakeholder engagement, leading to further work with both national and provincial governments.

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Chris Lübker


Chris is a health economist at Novo Nordisk A/S. His PhD with the Equity in Health Policy group was on health inequality measurement and impacts, including applying distributional cost-effectiveness analysis to the Universal Infant Free School Meal programme. Chris has also collaborated with the Organisation for Economic Co-Operation and Development on their efforts to document between- and within-country educational inequalities in life expectancy and inequalities in cancer prevention and care as part of Europe’s Beating Cancer Plan.

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Ieva Skarda


Ieva is an economist based at the Centre for Health Economics, University of York, working on new methods for evaluating childhood policies in terms of their lifetime effects on health, wellbeing and inequality. She has introduced a new life-course approach for evaluating childhood policies and developed LifeSim – a UK birth cohort microsimulation model to implement this approach in practice. Ieva’s methods have gained recognition among academics, senior policy analysts across local and central government institutions and think tanks. Ieva brings together international health equity researchers by organising annual health equity seminar series. Ieva has a PhD in economics from the University of York.

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Shrathinth Venkatesh


Shrathinth joined the Centre for Health Economics at York in May 2023 from the University of Michigan, USA, where he did postdoctoral research at the hospital and school of nursing. He completed his PhD in Labor Economics at the University of Wisconsin, Milwaukee in 2021.  His work has been in both education and health and he is now working on building a micro-simulation model for children in the UK.