Abstract

Objectives

Health systems in Latin America and the Caribbean face pressures from rising healthcare costs, inflation, and limited revenue growth. Rationalizing inappropriate or unnecessary uses of technologies can enhance efficiency and sustainability. Disinvesting in obsolete or ineffective technologies is a key part of that effort. This study aims at measuring and quantifying the potential savings from disinvesting in the use of 6 candidate health technologies in the contributory regimen of the Dominican Republic. The analysis focuses on evaluating these savings and estimating the opportunity cost of such disinvestment.

Methods

The methodology consists of 4 key steps. First, the necessary data for analysis are identified from the contributory regimen of the Dominican Republic. Second, the baseline case for evaluation is defined. Third, the level of waste for each prioritized technology is estimated, along with the potential savings generated through divestment. Finally, the opportunity cost of reallocating these savings to selected cost-effective alternatives (best buys) is quantified, providing a comprehensive assessment of the impact of divestment.

Results

Six candidate health technologies for disinvestment were evaluated. Disinvestment in the candidate technologies could yield potential savings ranging from $122 113 to $8.6 million US dollars in the Dominican Republic. We present results in terms of how much those potential savings could contribute to (1) reducing coverage gaps for cost-effective interventions and (2) lead to quality-adjusted life-years gained.

Conclusions

This study demonstrates the potential of disinvesting in specific use of technologies to enhance health efficiency in the Dominican Republic.