Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge?

By H. Eichler, S. Kong, W. Gerth, P. Mavros, B. Jönsson. Value in Health, 2004

832 citations recorded by the source corpus.

BACKGROUND An increasing number of health-care systems, both public and private, such as managed-care organizations, are adopting results from cost-effectiveness (CE) analysis as one of the measures to inform decisions on allocation of health-care resources. It is expected that thresholds for CE ratios may be established for the acceptance of reimbursement or formulary listing. OBJECTIVE This paper provides an overview of the development of and debate on CE thresholds, reviews threshold figures (i.e., cost per unit of health gain) currently proposed for or applied to resource-allocation decisions, and explores how thresholds may emerge. DISCUSSION At the time of this review, there is no evidence from the literature that any health-care system has yet implemented explicit CE ratio thresholds. The fact that some government agencies have utilized results from CE analysis in pricing/reimbursement decisions allows for retrospective analysis of the consistency of these decisions. As CE analysis becomes more widely utilized in assisting health-care decision-making, this may cause decision-makers to become increasingly consistent. CONCLUSIONS When CE analysis is conducted, well-established methodology should be used and transparency should be ensured. CE thresholds are expected to emerge in many countries, driven by the need for transparent and consistent decision-making. Future thresholds will likely be higher in most high-income countries than currently cited rules of thumb.

Subfields: Economics and Econometrics, General Health Professions

View Paper: https://www.semanticscholar.org/paper/37483fa80bd29e3ab807dd55821446a15d6fc073

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Citations in the corpus

Multiple criteria decision analysis for health technology assessment. (2012, background): “Health policy decision makers internationally so far have been considering cost-per-QALY ratios alongside other criteria, such as equity and fairness and prioritization of interventions for vulnerable populations, in a deliberative manner [20].”
Case finding for the management of osteoporosis with FRAX®—assessment and intervention thresholds for the UK (2008, background): “The WTP threshold has been suggested to be somewhere between one to three times GDP/capita [24].”
Cost of disorders of the brain in Europe (2005, background): “There is no agreed value for a QALY in Europe, and to assure a conservative, estimate the value was set to GDP/capita in Europe (Eichler et al., 2004)6.”