ISSUE: The cost-effectiveness threshold has been central to how cost-effectiveness analysis has been used to support technology funding decisions. There has been extensive debate in many countries about the level of the threshold and what evidence can be used to inform this. The Panel will debate the question of whether the threshold should be an evidence-based quantification and, if so, what evidence should be used. Nakamura will moderate the session and outline the role of cost-effectiveness thresholds, with a particular focus on policy developments in Japan. Sculpher will argue that there is a role for different types of evidence in guiding resource allocation in health, but empirical estimates of opportunity costs should inform technology funding decisions. Teerawattananon will explain how Thailand has set and adjusted its thresholds and what lessons there are for other countries in the region. Karnon will discuss the Australian approach to making funding recommendations for new pharmaceuticals, in which an explicit threshold is not set, but individual thresholds are defined for individual pharmaceuticals. OVERVIEW: All health care systems need to consider the costs of medical intervention as well as their effectiveness, reflecting that there are never sufficient resources in health care to fund all interventions at any price. Cost-effectiveness analysis is used in many countries, including in the Asia Pacific region, to support funding decisions. It requires a consideration of what cost is reasonable to incur for an additional unit of benefit (e.g. QALY gained or DALY averted). Some health systems are explicit about this ‘cost-effectiveness threshold’, but most operate an implicit range. Given the threshold’s importance in guiding decisions, some have argued that it should be based on appropriate evidence, but what type of evidence should be used? One approach is to estimate the public’s willingness to pay for additional health, which has been called a ‘demand-side threshold’. An alternative is to base the threshold on the health benefits that could have been generated by the system if the cost of a new intervention had been spent elsewhere, the ‘opportunity costs’ or the ‘supply-side threshold’. Which, if any, evidence should be used?