PURPOSE

: 1) Illustrate how empirical work can inform cost-effectiveness thresholds based on opportunity cost

2) Discuss the challenges for HTA bodies and payers in selecting a threshold

DESCRIPTION

: Cost-effectiveness thresholds are a key element of decision making in many countries. It is now recognised that these thresholds need to be grounded in evidence about the improvements in health that could be achieved by using resources for other activities in the health system (opportunity costs), and research is underway in several countries to provide that evidence. We will reflect on whether there is any emerging consensus on good practice in empirical work of this kind, and consider the views of HTA and payer bodies about what evidence they think should inform the choice of a threshold.

Professor Nancy Devlin – why is this important? (10 mins) – Nancy will emphasise the importance of exploring the empirical basis for cost-effectiveness thresholds based on opportunity cost and overview approaches that might be taken to inform this kind of work, highlighting challenges and limitations.

Dr James Lomas – methods for estimation (10 mins) – James will draw good practice lessons for using econometric analysis to estimate health opportunity costs.

Dr Martin Henriksson – estimation and impact in Sweden (10 mins) – as both a researcher and a decision maker on behalf of TLV, Martin will explore lessons from work in this area in Sweden. He will focus on how the opportunity cost work can inform trade-offs concerning severity of disease and rarity, both explicitly considered in Swedish healthcare prioritisation.

Danny Palnoch – how is this evidence used? (15 mins) – as Head of Medicines Analysis for NHS England, Danny directly inputs into decisions concerning the ~£17.4 billion spent on medicines in England. Danny will highlight challenges associated with policy using this evidence and suggest future research.