ISSUE: An important barrier to the widespread adoption of cost-effectiveness analysis for decision making is that there is no widely accepted “decision rule” that could be used worldwide (i.e. what is cost-effective in my country or jurisdiction?). Recent studies seriously challenge the previous WHO "rule of thumb" considering cost-effective a strategy that gains a healthy year at less than 3 GDPs per capita.  OVERVIEW: The definition and use of cost-effectiveness thresholds (CETs) is a topic under discussion at the global level. The panel will debate the role of CETs in Latina American health care systems. Andres Pichon-Riviere will briefly introduce the concept of CET and the main methodological approaches to derive them. Vania Canuto provides the perspective of a country that requires cost-effectiveness but does not have an explicit CET: Has cost-effectiveness information been useful in guiding decisions even in the absence of a CET? What have been the advantages and disadvantages of not having a CET? Has Brazil explored methodologies to estimate a CET? Hector Castro will present the perspective of three countries (Colombia, Chile, and Mexico) that defined CETs in their methodological guidelines for conducting health economic evaluations. His presentation will briefly discuss the methodologies and foundations used by these three countries to define CETs. Lou Garrison provides the perspective of those that advocate for a broader concept of value. He will discuss the challenges and limitations of defining and applying thresholds, and their implications for international financing of R&D. He will also discuss recent efforts that attempt to expand the concept of value that is represented in cost-effectiveness analysis. After a 5 minutes introduction, each panelist will speak for 10 minutes. This will be followed by a 10-minute panel discussion, and 15 minutes of Q&A from the audience.