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Erschienen in: PharmacoEconomics 5/2018

01.05.2018 | Leading Article

Cost-Effectiveness Thresholds: the Past, the Present and the Future

verfasst von: Praveen Thokala, Jessica Ochalek, Ashley A. Leech, Thaison Tong

Erschienen in: PharmacoEconomics | Ausgabe 5/2018

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Abstract

Cost-effectiveness (CE) thresholds are being discussed more frequently and there have been many new developments in this area; however, there is a lack of understanding about what thresholds mean and their implications. This paper provides an overview of the CE threshold literature. First, the meaning of a CE threshold and the key assumptions involved (perfect divisibility, marginal increments in budget, etc.) are highlighted using a hypothetical example, and the use of historic/heuristic estimates of the threshold is noted along with their limitations. Recent endeavours to estimate the empirical value of the thresholds, both from the supply side and the demand side, are then presented. The impact on CE thresholds of future directions for the field, such as thresholds across sectors and the incorporation of multiple criteria beyond quality-adjusted life-years as a measure of ‘value’, are highlighted. Finally, a number of common issues and misconceptions associated with CE thresholds are addressed.
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Fußnoten
1
CE thresholds reflecting opportunity costs can also be used to calculate the net benefit of an intervention (i.e. if net health benefit, benefit in terms of health over and above health opportunity costs).
 
2
As described earlier, the shadow price of 0.0001818 relates to intervention B and as such is only applicable for a range of budgets between £42 million (i.e. total costs of fully funded A and D) and £64 million (i.e. total costs of fully funded A, D and B).
 
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Metadaten
Titel
Cost-Effectiveness Thresholds: the Past, the Present and the Future
verfasst von
Praveen Thokala
Jessica Ochalek
Ashley A. Leech
Thaison Tong
Publikationsdatum
01.05.2018
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 5/2018
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.1007/s40273-017-0606-1

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