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Establishing multiple cost-effectiveness thresholds in Oman: a stakeholder-driven approach.

Said Wani1,2,3, Hilal Alsabti4, Said Allamki4

  • 1Center for Health Technology Assessment, Semmelweis University, Ulloi ut 25, Budapest, 1085, Hungary. said.rashdi@phd.semmelweis.hu.

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Summary

Oman established cost-effectiveness thresholds (CETs) using GDP per capita. Thresholds vary from 1x GDP for common diseases to 12x GDP for rare, priority diseases, guiding healthcare technology adoption.

Keywords:
CETCost-effectiveness thresholdCost-effectiveness threshold multiplierEconomic evaluationHealth technology assessmentMultiple thresholdsOman

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Area of Science:

  • Health Economics
  • Health Policy
  • Value-Based Healthcare

Background:

  • Rising healthcare technology costs and budget constraints challenge global health systems, including Oman.
  • Local value judgments are essential for effective healthcare decision-making.
  • Establishing cost-effectiveness thresholds (CETs) is crucial for aligning new health technologies with Oman's economic status and priorities.

Purpose of the Study:

  • To develop a framework for cost-effectiveness thresholds (CETs) tailored to Oman's specific economic context and healthcare priorities.
  • To inform decision-making regarding the adoption of new health technologies within the Omani healthcare system.

Main Methods:

  • A multi-stakeholder workshop was conducted in March 2024 to discuss global CET practices.
  • A survey was administered to gather expert opinions on key aspects of CET framework design.
  • Voting results guided the establishment of agreed-upon threshold values and multipliers.

Main Results:

  • A consensus was reached to adopt multiple CET values, linked to Gross Domestic Product (GDP) per capita.
  • A baseline CET of 1x GDP per capita was proposed.
  • Multiple multipliers were recommended: a continuous multiplier (1-3x GDP) based on quality-adjusted life-year (QALY) gains and a fixed multiplier of 2 for orphan drugs and priority diseases.

Conclusions:

  • For common diseases with minimal health gains, the incremental cost per QALY should not exceed 1x GDP per capita.
  • For curative treatments of rare, priority diseases, thresholds can increase up to 12x GDP per capita.
  • Recommended review and update of CET values within three years based on implementation experience.