OBJECTIVES: Estimating the critical threshold value from previous reimbursement decisions is one of the several methods to determine a cost effectiveness threshold. The methodology is based on analyzing the relationship between the Incremental Cost Effectiveness Ratio (ICER) of the assessed health technologies, and the reimbursement decisions.  Our study tries to examine if there is any relationship between cost effectiveness and decision making in Hungary by analyzing data abstracted from HTA appraisals and health economic studies. METHODS: The members of the HTA Department examined the submissions containing a cost-utility analysis  which were assessed by the Hungarian HTA Office since 2004. We created a database in which we summed up the cost/QALY values of the examined submissions and HTA reports. We analyzed the appraisal determinations of the HTA Committee regarding the assessed submissions in order to examine the likelihood of a positive/negative decision according the level of the assessed pharmaceutical’s ICER value. We searched for the technology with the highest ICER value, which got reimbursed. RESULTS: We examined 165 submissions which contained a cost-utility analysis that have arrived to our Department. Our results suggest that there is only a weak correlation (r=0,14) between the level of the calculated ICER and the reimbursement decisions. We found, that the highest ICER which resulted a positive reimbursement decision was 9 500 000 HUF/QALY (32 000 EUR). CONCLUSIONS: One of the several methods to determine a threshold value is to examine the relationship between previous reimbursement decisions and ICER values calculated in health economic appraisals. However one must take into account, that estimating a threshold value based on prior decisions has limitations, as reimbursement decisions are almost never made based on ICER ratios alone. This could be the main reason our study only showed a weak correlation between the level of calculated ICERs and the outcomes of the determinations.