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Objectives, Budgets, Thresholds, and Opportunity Costs-A Health Economics Approach: An ISPOR Special Task Force
Patricia M Danzon1, Michael F Drummond2, Adrian Towse3
1Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
Summary
Health plans use budgets and cost-effectiveness thresholds to decide on technology adoption. Consistent use of cost-per-quality-adjusted life-year thresholds maximizes health gains within budget constraints.
Area of Science:
- Health Economics
- Health Technology Assessment
- Health Policy
Background:
- Health plans face complex decisions regarding technology adoption and reimbursement.
- Evaluating new technologies requires balancing value, cost, and budget constraints.
Purpose of the Study:
- To outline decision-making frameworks for health plans regarding technology adoption and reimbursement.
- To explore the roles of budgets, cost-effectiveness thresholds, and affordability in these decisions.
Main Methods:
- Discussion of budget impact, cost-per-quality-adjusted life-year (QALY) thresholds, and opportunity costs.
- Analysis of affordability considerations, including disinvestment and comparative cost-effectiveness.
- Examination of factors modifying thresholds, such as evidence uncertainty.
Main Results:
- Health plans should establish decision rules and consistently apply cost-per-QALY thresholds to maximize health gains.
- Different thresholds in US public and private plans reflect budget variations and impact technology access.
- Affordability requires strategic approaches like disinvestment and managing adjustment costs.
Conclusions:
- Implementing consistent cost-effectiveness thresholds is crucial for optimal resource allocation in healthcare.
- The US pluralistic system necessitates tailored approaches to technology adoption decisions.
- Understanding affordability and opportunity costs is key for sustainable healthcare systems.
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