All healthcare systems face difficult decisions around how to allocate scare resources to generate improvements in population health. In low- and middle-income countries (LMICs) these challenges are compounded by considerably greater resource constraints than those faced by high-income countries. Determining whether an intervention, be it a drug, diagnostic, device or otherwise, is good value for money requires a comparison with an appropriate benchmark value, often referred to in the literature as a “threshold”. These benchmark values are useful not only for government decision makers, but also for donors who may be contributing to the overall funding of a health care system or toward specific interventions or programs as well as those looking to fund the development of new health interventions. They can also be used to prioritise between a set of cost-effective interventions through comparison of population net benefit estimates.
LMICs increasingly are looking toward using cost-effectiveness analysis to inform decision making in healthcare; however, the benchmark values commonly recommended for use by advisory bodies are those that reflect ‘demand side’ estimates. To date, the only existing estimates of health opportunity costs for LMICs are based on cross-country data (see Publications tab).
Thokala P, Ochalek J, Leech A, Tong T. Cost effectiveness thresholds: the past, the present and the future. PharmacoEconomics 2018;36(5)509-522. Download from Springer
Nakamura N, Lomas J, Claxton K, Bokhari F, Moreno-Serra R, Suhrcke M. Assessing the impact of health care expenditures on mortality using cross-country data. Centre for Health Economics, University of York;CHE Research Paper 128 (PDF , 2,039kb) 2016.
Woods B, Revill P, Sculpher M, Claxton K. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value in Health 2016:19(8):929-35.
Ochalek J, Lomas J, Claxton K. Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data. Centre for Health Economics, University of York;CHE Research Paper 122 (PDF , 2,322kb) 2015.
Woods B, Revill P, Sculpher M, Claxton K. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Centre for Health Economics, University of York;CHE Research Paper 109 (PDF , 2,894kb) 2015.
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