Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States

Cost-effectiveness analysis is an important tool for informing treatment coverage and pricing decisions. However, there is no consensus on whether threshold for the incremental cost-effectiveness ratio (ICER) in dollars per quality-adjusted life-year (QALY) gained indicates whether treatments are likely to be cost-effective in the United States. To that end, Lomas et al. performed a study aimed at estimating U.S. cost-effectiveness threshold based on health opportunity costs. They found that in the context of current evidence, treatments with ICERs above the range $100 000 to $150 000 per QALY are unlikely to be cost-effective in the United States. Read the full article here.

(Source: James Lomas, Hannah Ahn, et al. A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States. Annals of Internal Medicine 0;0 [Epub ahead of print 3 November 2020]. doi:https://doi.org/10.7326/M20-1392)