Health Opportunity Cost Threshold for CEA in the U.S.
2021
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and morbidity, per increase of $10,000,000 in population treatment costs. In addition to reporting that 1,860 people were expected to become uninsured due to this increase, 5 deaths, 81 QALYs (from these deaths) and 15 QALYs due to untreated illness would result, leading to an implied threshold of $104,000 per QALY. The authors conclude that given current evidence, treatments with ICERs above the range $100 000 to $150 000 per QALY are unlikely to be cost-effective in the United States.
Health Opportunity Cost Threshold for CEA in the U.S.
Source:
Vanness DJ, Lomas J, Ahn H. A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States. Annals of Internal Medicine 2021; 174 (1): 25-32. https://doi.org/10.7326/M20-1392
Not open access.