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Quality-Adjusted Life Expectancy and Cost-Effectiveness Thresholds in Three High-Income Regions in Asia
1School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, China.
Applied Health Economics and Health Policy
|April 11, 2026
Summary
This study estimates cost-effectiveness thresholds (CETs) and quality-adjusted life expectancy for Hong Kong, Taiwan, and Singapore. The findings provide crucial data for health technology assessments in these Asian regions.
Area of Science:
- Health Economics
- Public Health Policy
- Biostatistics
Background:
- Cost-effectiveness thresholds (CETs) are vital for healthcare resource allocation and health technology assessments.
- Empirical CET estimates and quality-adjusted life expectancy data were previously lacking for Hong Kong SAR, Taiwan Province, and Singapore.
- This research addresses this gap by estimating these key metrics for the specified regions.
Purpose of the Study:
- To estimate quality-adjusted life expectancy at birth for Hong Kong SAR, Taiwan Province, and Singapore.
- To derive context-specific cost-effectiveness thresholds (CETs) for these regions using a value of a statistical life-based method.
- To provide a scientific basis for health technology assessments and policy decisions in high-income Asian economies.
Main Methods:
- Quality-adjusted life expectancy was calculated using the Sullivan method.
- Cost-effectiveness thresholds (CETs) were estimated via a value of a statistical life-based approach, incorporating age-specific life expectancy and health utilities.
- Population-weighted values of statistical quality-adjusted life-year were used to determine regional CETs, with adjustments for overestimation and sensitivity analyses.
Main Results:
- Estimated quality-adjusted life expectancy at birth: 79.98 years (Hong Kong SAR), 76.73 years (Taiwan Province), and 79.48 years (Singapore).
- Base-case CETs as multiples of GDP per capita: 3.12 (Hong Kong SAR), 2.15 (Taiwan Province), and 3.30 (Singapore).
- Sensitivity analyses confirmed CET ranges, indicating robustness across different utility and discount rate assumptions.
Conclusions:
- This study presents the first value of a statistical life-based CET estimates integrated with quality-adjusted life expectancy for Hong Kong SAR, Taiwan Province, and Singapore.
- The derived context-specific thresholds offer a more relevant benchmark than global standards like WHO benchmarks.
- These findings provide essential evidence to support health technology assessments and inform healthcare policy in these high-income Asian regions.
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