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Marginal cost per QALY estimates: What are they good for?

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  • Sampson, Chris
  • Cookson, Graham

Abstract

Estimates of the marginal cost per quality-adjusted life year (MCPQ) are available for health care systems worldwide. Researchers routinely make claims about these estimates and how they should inform policymaking. This commentary considers these claims by taking a recent article from Health Policy as a case study. Claims are made about the past performance of the health service and about future decisions and relate to such considerations as productivity, the impact of technology approvals, cost-effectiveness thresholds, and budget allocation. We argue that the evidence does not justify these claims and MCPQ estimates should instead inform questions about the consequences of changes in expenditure.

Suggested Citation

  • Sampson, Chris & Cookson, Graham, 2024. "Marginal cost per QALY estimates: What are they good for?," Health Policy, Elsevier, vol. 142(C).
    • Handle: RePEc:eee:hepoli:v:142:y:2024:i:c:s0168851024000460
    DOI: 10.1016/j.healthpol.2024.105036
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    References listed on IDEAS

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    1. Brekke, Kurt R. & Dalen, Dag Morten & Straume, Odd Rune, 2023. "The price of cost-effectiveness thresholds under therapeutic competition in pharmaceutical markets," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Laura C. Edney & James Lomas & Jonathan Karnon & Laura Vallejo-Torres & Niek Stadhouders & Jonathan Siverskog & Mike Paulden & Ijeoma P. Edoka & Jessica Ochalek, 2022. "Empirical Estimates of the Marginal Cost of Health Produced by a Healthcare System: Methodological Considerations from Country-Level Estimates," PharmacoEconomics, Springer, vol. 40(1), pages 31-43, January.
    3. Chris Sampson & Bernarda Zamora & Sam Watson & John Cairns & Kalipso Chalkidou & Patricia Cubi-Molla & Nancy Devlin & Borja García-Lorenzo & Dyfrig A. Hughes & Ashley A. Leech & Adrian Towse, 2022. "Supply-Side Cost-Effectiveness Thresholds: Questions for Evidence-Based Policy," Applied Health Economics and Health Policy, Springer, vol. 20(5), pages 651-667, September.
    4. Bram Wouterse & Pieter Baal & Matthijs Versteegh & Werner Brouwer, 2023. "The Value of Health in a Cost-Effectiveness Analysis: Theory Versus Practice," PharmacoEconomics, Springer, vol. 41(6), pages 607-617, June.
    5. Martin, Stephen & Claxton, Karl & Lomas, James & Longo, Francesco, 2023. "The impact of different types of NHS expenditure on health: Marginal cost per QALY estimates for England for 2016/17," Health Policy, Elsevier, vol. 132(C).
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