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What next after GDP-based cost-effectiveness thresholds?
- Source :
- Gates Open Research
- Publication Year :
- 2020
- Publisher :
- F1000 Research Limited, 2020.
-
Abstract
- Public payers around the world are increasingly using cost-effectiveness thresholds (CETs) to assess the value-for-money of an intervention and make coverage decisions. However, there is still much confusion about the meaning and uses of the CET, how it should be calculated, and what constitutes an adequate evidence base for its formulation. One widely referenced and used threshold in the last decade has been the 1-3 GDP per capita, which is often attributed to the Commission on Macroeconomics and WHO guidelines on Choosing Interventions that are Cost Effective (WHO-CHOICE). For many reasons, however, this threshold has been widely criticised; which has led experts across the world, including the WHO, to discourage its use. This has left a vacuum for policy-makers and technical staff at a time when countries are wanting to move towards Universal Health Coverage. This article seeks to address this gap by offering five practical options for decision-makers in low- and middle-income countries that can be used instead of the 1-3 GDP rule, to combine existing evidence with fair decision-rules or develop locally relevant CETs. It builds on existing literature as well as an engagement with a group of experts and decision-makers working in low, middle and high income countries.
- Subjects :
- Cost effectiveness
Psychological intervention
Medicine (miscellaneous)
Commission
Biochemistry, Genetics and Molecular Biology (miscellaneous)
03 medical and health sciences
0302 clinical medicine
Immunology and Microbiology (miscellaneous)
Economics
Per capita
030212 general & internal medicine
Meaning (existential)
Public economics
030503 health policy & services
Health Policy
Public Health, Environmental and Occupational Health
cost-effectiveness analysis
Cost-effectiveness analysis
Articles
Cost-effectiveness thresholds
priority setting
Intervention (law)
health opportunity cost
HD28
Open Letter
0305 other medical science
High income countries
Subjects
Details
- Language :
- English
- ISSN :
- 25724754
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Gates Open Research
- Accession number :
- edsair.doi.dedup.....2b464f2c2e41e1a8446b752bd2991151