Posted on 20 August 2015
Centre for Health Economics staff and their research were well represented at the recent International Decision Support Initiative (iDSI) meeting on cost-effectiveness thresholds. The event, co-organised by NICE International and CHE, took place in London on 26 June 2015, and saw the announcement by the WHO of the removal of its guidance on the use of GDP-based cost-effectiveness thresholds.
The varied programme of events, which included Karl Claxton, Marc Suhrcke and Ryota Nakamura delivering presentations on York’s thresholds research, sparked debate around the use of GDP-based cost-effectiveness thresholds in health policy decision making in low- and middle-income countries (LMICs).
Current widespread use of the 1 – 3 x GDP per capita based cost-effectiveness thresholds in healthcare intervention decision making and resource allocation was discussed. CHE research revealing the inaccuracy and potentially detrimental effect of using this measure was cited to support the re-evaluation of WHO guidance in this area. Discussions, led by CHE researchers, highlighted the importance of determining the opportunity-costs incurred by intervention policies, with York championing the consideration of supply when estimating cost-effectiveness thresholds in order for policy makers in LMICs to make informed decisions.
Similarly, there was great interest in the results of the Claxton et al. (2015) research which found that the UK cost-effectiveness threshold should ideally be closer to £13,000 per quality adjusted life year (QALY) in comparison to current arrangements where interventions below £50,000 per QALY are typically approved as cost-effective by NICE.
Event proceedings concluded with WHO representatives announcing the removal of WHO guidance pertaining to the use of the 1 – 3 x GDP per capital based thresholds in decision making, and the start of a review into alternative threshold estimation methods. CHE’s research was recognised as providing key evidence to support this decision, and its researchers are likely to be involved in future investigations into alternative thresholds.
A summary of the iDSI Thresholds Meeting can be viewed here iDSI Summary report (PDF , 635kb).