OBJECTIVES: The discount rate (R) currently required for costs and effects in official pharmacoeconomic analysis in the Slovak Republic is 5% per year, one of the highest discount rates in the world. An official calculation used to validate the 5% rate is based on old data and therefore questionable.

We provide an updated estimate of R underpinned by the strongest rationale across the different approaches. We also provide a set of recommendations for consideration by decision-makers which would improve discounting practice in pharmacoeconomic analysis.

METHODS: Our base case estimates come from estimating the social rate of time preference for consumption using the Ramsey Rule. This is a common way of estimating an appropriate social discount rate and makes use of country-specific macroeconomic and demographic data.

RESULTS: A reference case discount rate of 3.3% per year is the most appropriate for the evaluation of public programs in the Slovak Republic, including healthcare programs and reimbursement of new health technologies. Upper and lower bounds of the estimate are set to 3.0% and 5.3%.

The difference between our best estimate and the existing one is explained by the fact we use average growth in real consumption per capita (1.75% for 2010-2019) instead of average growth in real aggregate GDP (3.3% for 2010-2020).

CONCLUSIONS: Our recommendations include: lower the reference case discount rate to 3.3% per year; explore whether differential discounting is appropriate for either the reference case or sensitivity analysis; update the discount rate range for sensitivity analysis in line with the new reference case rate(s); explore whether it is appropriate to apply a lower discount rate to long-term costs and effects; ensure the discount rate and discounting method is consistent with other public sectors; and continue to update the discount rate every four to five years in line with updates to HTA methods in other countries