Comment on: “Are Current Cost-Effectiveness Thresholds for Low- and Middle-Income Countries Useful? Examples from the World of Vaccines”

Excerpt

The article by Newall et al. [1] published recently in PharmacoEconomics presents a valuable summary of potential approaches of setting cost-effectiveness thresholds when facing scarce healthcare resources. One approach suggested by the World Health Organization (WHO) is to set cost-effectiveness thresholds according to gross domestic product (GDP). The article then discusses why these methods have not been used for the allocation of healthcare resources. The authors are right to point out that, beyond the criterion of cost-effectiveness, budget impact is of particular importance to decision makers. Yet, the WHO approach of setting a cost-effectiveness threshold does not adequately consider budget impact. In addition to cost-effectiveness and budget impact, there are other criteria (e.g. equity) that may also need to be considered. The particular focus of the article is low- and middle-income countries (LMICs), although in principle the ideas also apply to high-income countries (HICs). …