OBJECTIVES:  Recent trends in Bosnia and Herzegovina (BH) are towards reimbursement decisions based on pharmacoeconomic evaluation. Legislation requires pharmacoeconomic analysis as a part of reimbursement dossier. Even legislation does not exactly propose which analysis should be presented; reimbursement files mainly consist of budget impact, cost minimization and cost effectiveness (CE) analysis for innovative expensive drugs. No exact CE threshold is set, we calculated and proposed CE threshold which could be applicable as decision criteria which are missing. Having this reimbursement process would be more transparent and accelerated. Since medicines are financed through public reimbursement funds, proposed threshold could be considered from societal perspective. METHODS:  We have applied two approaches in establishing CE threshold We proposed World health organization (WHO) threshold ranging from 1 to 3 per capita Gross Domestic Product (GDP) and annual cost of dialysis. GDP used in a calculation is taken from BH Agency for Statistics report, while costs of dialysis have been taken from the reports on expenditure from national insurance funds and published data from previous publications. RESULTS:  Using GDP per capita as basis for CE threshold calculation in BH it should be in a range from 3.642€ to 10.926€. Calculating average cost of dialysis per patient per year in BH CE threshold should be set on level of 19.904€. We found that CE threshold based on 3xGDP is 55% lower than CE threshold calculated on the basis of annual dialysis cost per patient in Bosnia and Herzegovina. CONCLUSIONS:  In order to ensure access to novel therapeutics it is preferable to use CE threshold based on dialysis cost than GDP based calculation. On the other hand from the payer perspective in terms of cost containment GDP based calculation is preferable. Other alternative methods for CE threshold calculation should be examined in the future.