Marzia Zambon, President of Europa Donna Albania, shared Neil Grubert’s post on LinkedIn:
“Does your country have a cost effectiveness threshold in their HTA evaluation process?
EPFIA issued a publication comparing the 27 EU countries plus others (including UK, CH, and Norway”
Quoting Neil Grubert, Independent Global Market Access Consultant, on LinkedIn:
“How do cost-effectiveness (CE) thresholds vary among countries that practise health economic evaluation? EFPIA recently commissioned an analysis by Charles River Associates of practice in 36 countries: the 27 EU Member States plus Australia, Canada, Japan, New Zealand, Norway, South Korea, Switzerland, the United Kingdom and the United States. The study had a particular focus on the United Kingdom.
The authors found that eight countries – Hungary, Ireland, Japan, the Netherlands, Poland, Slovakia, Slovenia and the United Kingdom – have explicit CE thresholds. A further 14 countries – Australia, Belgium, Bulgaria, Canada, Czech Republic, Estonia, Greece, Italy, Latvia, Lithuania, Norway, Poland, Portugal and South Korea – have implicit CE thresholds.
The average CE threshold is £33,400 per QALY gained. As the accompanying figure shows, Poland has the highest CE threshold – just over £50,000 per QALY, which is more than double the country’s GDP per capita. Fifteen countries have CE thresholds that are higher than their GDP per capita. Ten countries have CE thresholds that are lower than their GDP per capita. In Ireland and Norway, the CE thresholds are less than half their respective GDP per capita values.
The study found that 13 countries use formal modifiers for factors such as disease rarity, disease severity or specific therapeutic areas. England, for example, has severity modifiers of 1.2 or 1.7 that can boost the QALY weighting.
Twenty-seven countries take account of budget impact in their HTA processes. However, only five countries have formal budget impact thresholds.
As the use of health economic evaluation increases around the world, questions related to CE thresholds, modifiers and budget impact thresholds will grow in importance for the industry.”
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