OBJECTIVES: In January 2017, the Danish Medicines Council (DMC) was founded with the purpose of assessing and providing guidance on new inpatient medicines. Since January 2021, the DMC has required that submissions include a cost-utility analysis, which incorporates quality-adjusted life-years (QALYs) and results in an incremental cost-effectiveness ratio (ICER). Oncology treatments constitute a substantial amount of the medicine assessed. As there is no official willingness to pay (WTP) threshold for oncology treatments in Denmark, the aim of this study was to estimate the WTP threshold for oncology treatments in Denmark.

METHODS: All cost-utility based DMC assessments on oncology treatments published until the 12^th of May 2023 were included in the analysis. To provide a conservative estimate of the WTP threshold, when the DMC assessment reported both an optimistic and a pessimistic ICER, the latter was included in the analysis, and decisions assessed as “partially positive” were included as positive. Additionally, this analysis is based on ICERs calculated with list prices in the DMC base case analyses, as ICERs resulting from AMGROS negotiations are confidential.

The WTP threshold was estimated by carrying out logistic regression using positive or negative recommendation as the dependent variable and ICERs as an independent variable. ROC curves were then created and the point on the ROC curve that maximizes the Youden index was identified.

RESULTS: A total of 23 assessments with available ICERs were included. A WTP threshold of 655,055 DKK/QALY was identified as the point on the ROC curve which would maximize the Youden’s index, resulting in the optimal balance between false positives and false negatives.

CONCLUSIONS: The estimated WTP threshold for oncology treatments in Denmark is approximately 650,000 DKK/QALY when based on list prices. As prices are often negotiated, it is very likely that the true WTP threshold is lower than our estimate.