Systematic overview of cost-effectiveness thresholds in ten countries across four continents

To provide an overview of thresholds for incremental cost-effectiveness ratios (ICERs) representing willingness-to-pay (WTP) across multiple countries and insights into exemptions pertaining to the ICER (e.g., cancer). To compare ICER thresholds to individual country's estimated ability-to-pay....

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Bibliographic Details
Published in:Journal of comparative effectiveness research 2015-09, Vol.4 (5), p.485-504
Main Authors: Schwarzer, Ruth, Rochau, Ursula, Saverno, Kim, Jahn, Beate, Bornschein, Bernhard, Muehlberger, Nikolai, Flatscher-Thoeni, Magdalena, Schnell-Inderst, Petra, Sroczynski, Gaby, Lackner, Martina, Schall, Imke, Hebborn, Ansgar, Pugner, Karl, Fehervary, Andras, Brixner, Diana, Siebert, Uwe
Format: Article
Language:English
Subjects:
Analysis
Cost-Benefit Analysis - economics
Cost-Benefit Analysis - statistics & numerical data
cost-effectiveness thresholds
Decision making
Health Expenditures - statistics & numerical data
Health policy
Humans
Internationality
Quality-Adjusted Life Years
reimbursement
technology assessment
willingness-to-pay
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Summary:To provide an overview of thresholds for incremental cost-effectiveness ratios (ICERs) representing willingness-to-pay (WTP) across multiple countries and insights into exemptions pertaining to the ICER (e.g., cancer). To compare ICER thresholds to individual country's estimated ability-to-pay. We included AHRQ/USA, BIQG-GOEG/Austria, CADTH/Canada, DAHTA@DIMDI/Germany, DECIT-CGATS/Brazil, HAS/France, HITAP/Thailand, IQWiG/Germany, LBI-HTA/Austria, MSAC/Australia, NICE/England/Wales and SBU/Sweden. ICER thresholds were derived from systematic literature/website search/expert surveys. WTP was compared with ATP using Spearman's rank correlation. Two general and explicitly acknowledged thresholds (England/Wales, Thailand), implicit thresholds in six countries and different ICER thresholds/decision-making rules in oncology were identified. Correlation between WTP and ability-to-pay was moderate. Our overview supports country-specific discussions on WTP and on how to define value(s) within societies.
ISSN:2042-6305
2042-6313
DOI:10.2217/cer.15.38