When is it too expensive? Cost-effectiveness thresholds and health care decision-making

Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge?

BACKGROUND An increasing number of health-care systems, both public and private, such as managed-care organizations, are adopting results from cost-effectiveness (CE) analysis as one of the measures to inform decisions on allocation of health-care resources. It is expected that thresholds for CE ratios may be established for the acceptance of reimbursement or formulary listing. OBJECTIVE This...

Health Economic Assessment: Cost-Effectiveness Thresholds and Other Decision Criteria

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The ob...

When are effective medications just too expensive?

Concept of Combining Cost-Effectiveness Analysis and Budget Impact Analysis in Health Care Decision-Making.

OBJECTIVES The objective of this study is to cover the ways of solving the problem of understanding the results of two key methods of pharmacoeconomic analysis - budget impact and cost-effectiveness. It is important to note that pharmacoeconomic assessment based on this evidence often has controversial character. The results of one type of analysis can characterize assessed health technology fa...

Cost-Effectiveness Analysis of Hepatitis B Immunization in Vietnam: Application of Cost-Effectiveness Affordability Curves in Health Care Decision Making

Objectives: To perform a cost-effectiveness analysis and to identify the cost-effectiveness affordability levels for a newborn universal vaccination program against hepatitis B virus (HBV) in Vietnam. Methods: By using a Markov model, we simulated a Vietnamese birth cohort using 1,639,000 newborns in 2002 and estimated the incremental cost-effectiveness ratios for quality-adjusted life-year gai...