International experience in determining the cost-effectiveness thresholds
T. P. Bezdenezhnykh,
N. Z. Musina,
V. K. Fedyaeva,
T. S. Tepcova,
V. A. Lemeshko,
V. V. Omelyanovsky https://doi.org/10.17749/2070-4909.2018.11.4.073-080
Abstract
The article reviews international methodological guidelines, regulatory documents and existing approaches to the determination of the costeffectiveness threshold (CeT), also known as the willingness-to-pay threshold (WTP), the threshold value of the incremental cost-effectiveness ratio (ICeR), in europe (england and Wales, Scotland, Ireland, France, Belgium, Denmark, the netherlands, Germany, Sweden, Finland, norway, Poland), America (the USA, Canada, Brazil), Asia (Japan, South korea, Taiwan, Thailand), in Australia and new Zealand. The CeT is commonly used to rationalize decision-making in health cost reimbursement. The present review demonstrates that just a few countries (englandandWales,Thailand,Poland,USA) have introduced the explicit value of CeT into their decision making. Some countries (Australia,Canada,new Zealand, thenetherlands,Sweden, andBrazil) use CeT in an implicit manner implying that no specific CeT value is defined by law. In other countries (Finland,Sweden,norway,France,Germany,Denmark,Japan,South korea,Taiwan), the role of the threshold in health reimbursement remains uncertain despite the presence of HTA systems. The CeT is expressed as additional cost per unit of incremental health benefit, which is represented by quality-adjusted life year (QALY) in most counties. However,PolandandBrazilallow using life years gained (LYG) as a measure of additional benefit neglecting the quality of life. In thenetherlandsandengland, different CeT values are applied to the health technology under assessment depending on the severity or rareness of the disease and some other factors.
About the Authors
T. P. Bezdenezhnykh
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Tatiana P. Bezdenezhnykh – Leading Specialist;
Tel.: +7 (495) 783-19-05;
10-5 Khokhlovskii pereulok, Moscow 109028
N. Z. Musina
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation;
Research Financial Institution of the Ministry of Finance of the Russian Federation, Federal State Budget Institution;
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Nuriya Z. Musina – PhD, Head of the Department for the Development and Communications, Center for Healthcare Quality Assessment and Control, Ministry of Healthcare of the Russian Federation; Lecturer at the Department of Pharmacology, Faculty of Pharmacy, Sechenov Moscow Medical University;
Tel.: +7(495)6900480;
Researcher ID: C-8075-2018;
10-5 Khokhlovskii pereulok, Moscow 109028;
3-2 Nastasyinsky pereulok, Moscow 127006;
8-2 Trubetskaya Str., Moscow 119048
V. K. Fedyaeva
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation;
Research Financial Institution of the Ministry of Finance of the Russian Federation, Federal State Budget Institution
Russian Federation
Russian Federation
Vlada K. Fedyaeva – Chief Specialist, Department of Methodological Support of Comprehensive HTA, Center for Healthcare Quality Assessment and Control, Ministry of Healthcare of the Russian Federation; Laboratory Assistant at the Healthcare Finance Center, Research Financial Institute, Ministry of Finance of the Russian Federation;
Tel.: +7(499)9569528;
10-5 Khokhlovskii pereulok, Moscow 109028;
3-2 Nastasyinsky pereulok, Moscow 127006
T. S. Tepcova
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation;
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Tatiana S. Teptsova – PhD Student at the Department of Pharmacology, Institute of Pharmacy with the Sechenov Moscow State Medical University, Moscow, Russia; Leading Specialist, Center for Healthcare Quality Assessment and Control, Ministry of Healthcare of the Russian Federation; Graduate Student, Educational Department of the Institute of Pharmacy, Sechenov Moscow State Medical University, Ministry of Healthcare of the Russian Federation;
Tel.: +7 (495) 783-19-05;
10-5 Khokhlovskii pereulok, Moscow 109028;
8-2 Trubetskaya Str., Moscow 119048
V. A. Lemeshko
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation;
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Valeriya A. Lemeshko – PhD Student at the Department of Pharmacology, Institute of Pharmacy with the Sechenov Moscow State Medical University, Moscow, Russia; Leading Specialist, Center for Healthcare Quality Assessment and Control, Ministry of Healthcare of the Russian Federation;
Tel.: +7 (495) 783-19-05;
10-5 Khokhlovskii pereulok, Moscow 109028;
8-2 Trubetskaya Str., Moscow 119048
V. V. Omelyanovsky
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation;
Research Financial Institution of the Ministry of Finance of the Russian Federation, Federal State Budget Institution
Russian Federation
Russian Federation
Vitaliy V. Omelyanovskiy – MD, Professor, Head of the Healthcare Finance Center at the Research Financial Institute, Ministry of Finance of the Russian Federation;
Tel.: +7(499) 9569528;
Researcher ID: P-6911-2018; Scopus Author ID: 6507287753;
10-5 Khokhlovskii pereulok, Moscow 109028;
3-2 Nastasyinsky pereulok, Moscow 127006
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For citations:
Bezdenezhnykh T.P., Musina N.Z., Fedyaeva V.K., Tepcova T.S., Lemeshko V.A., Omelyanovsky V.V. International experience in determining the cost-effectiveness thresholds. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2018;11(4):73-80. (In Russ.) https://doi.org/10.17749/2070-4909.2018.11.4.073-080
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