Country-Level Cost-Effectiveness Thresholds
2016
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four countries. They calculate these estimates based on a) the recent empirical estimate obtained for the English National Health Service, b) estimates of the relationship between country GDP per capita and the value of a statistical life, and c) a series of explicit assumptions. CETs for Malawi (the country with the lowest income in the world), Cambodia (with borderline low/low-middle income), El Salvador (with borderline low-middle/upper-middle income), and Kazakhstan (with borderline high-middle/high income) were estimated to be $3 to $116 (1%–51% GDP per capita), $44 to $518 (4%– 51%), $422 to $1967 (11%–51%), and $4485 to $8018 (32%–59%), respectively. These estimates suggest that routinely used cost-effectiveness thresholds (based more heavily on GDP) have been too high.
Country-Level Cost-Effectiveness Thresholds
Source:
Woods B, Revill P, Sculpher M et al. Country-Level Cost-Effectiveness Thresholds: Initial Estimates and the Need for Further Research. Value in Health 2016; 19 (8): 929-935. http://dx.doi.org/10.1016/j.jval.2016.02.017