SUPPLY-SIDE COST-EFFECTIVENESS THRESHOLD ESTIMATE FOR HUNGARY
Author(s)
Peter G. Balázs, PhD, Valentin Brodszky, MSc, PhD, MD.
Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
OBJECTIVES: Cost-effectiveness thresholds (CETs) define the maximum amount a healthcare decision-makers are willing to pay for one additional unit of health gain generated by a new/alternative intervention. The approaches used to determine the optimal CET range or value vary widely and remain a subject of ongoing debate. The aim of this study was to estimate a supply-side CET from the perspective of the Hungarian National Health Insurance Fund.
METHODS: Quality-adjusted life years (QALY) was calculated for the male, female, and total population aged 0-99 years to estimate the impact of total per capita healthcare expenditure between 2004 and 2024. For each year, hypothetical cohorts were followed throughout their lifetime using respective life table data, with life years weighted by the Hungarian EQ-5D-5L utility population normative values. Log-log time-series regression models were used to estimate the elasticity between healthcare expenditure and QALY.
RESULTS: Over the study period, real healthcare expenditure increased, which was associated with an increase in QALE in the male, female, and total populations, with expenditure elasticities of β= 0.11, 0.04 and 0.07, respectively. These estimates correspond to a supply-side cost per QALY gained ranging from 5.1 to 11.4 million HUF (~ €12,800-28,700 at 2025 real prices) corresponding to approximately 0.56-1.26 times the Hungarian GDP per capita. Both β coefficients and corresponding CET values decreased with the starting age of the cohorts and were consistently lower for males than for females.
CONCLUSIONS: Our CET estimate is important information for decision-making process regulations, given that misallocation of limited public resources is particularly harmful in countries with low public health spendings, like Hungary. Although supply-side thresholds do not determine which interventions should be prioritized, the combination of population life tables and health-state utility data offers a more evidence-based decision aid than conventional rule-of-thumb CET approaches.
METHODS: Quality-adjusted life years (QALY) was calculated for the male, female, and total population aged 0-99 years to estimate the impact of total per capita healthcare expenditure between 2004 and 2024. For each year, hypothetical cohorts were followed throughout their lifetime using respective life table data, with life years weighted by the Hungarian EQ-5D-5L utility population normative values. Log-log time-series regression models were used to estimate the elasticity between healthcare expenditure and QALY.
RESULTS: Over the study period, real healthcare expenditure increased, which was associated with an increase in QALE in the male, female, and total populations, with expenditure elasticities of β= 0.11, 0.04 and 0.07, respectively. These estimates correspond to a supply-side cost per QALY gained ranging from 5.1 to 11.4 million HUF (~ €12,800-28,700 at 2025 real prices) corresponding to approximately 0.56-1.26 times the Hungarian GDP per capita. Both β coefficients and corresponding CET values decreased with the starting age of the cohorts and were consistently lower for males than for females.
CONCLUSIONS: Our CET estimate is important information for decision-making process regulations, given that misallocation of limited public resources is particularly harmful in countries with low public health spendings, like Hungary. Although supply-side thresholds do not determine which interventions should be prioritized, the combination of population life tables and health-state utility data offers a more evidence-based decision aid than conventional rule-of-thumb CET approaches.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE74
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas