Distributional cost-effectiveness analysis (DCEA) provides information about the equity impacts of health technologies and programs and the trade-offs that sometimes arise between equity and efficiency. This field has now come of age with a growing applied literature,¹ new training resources,² and a formal professional network: a special interest group on equity-informative economic evaluation within the International Health Economics Association.³

A systematic review published in this issue of Value in Health¹ found 54 peer-reviewed studies published to date, mostly after 2015, relating to diverse disease categories, intervention types, and populations and using various equity criteria, with socioeconomic status and race/ethnicity being the most frequent. Most reviewed studies (78%) found a favorable equity impact of the health program under investigation, and only 6% found an unfavorable equity impact.