Assessing cost-effectiveness in healthcare: history of the $50,000 per QALY threshold
- 1 April 2008
- journal article
- Published by Informa UK Limited in Expert Review of Pharmacoeconomics & Outcomes Research
- Vol. 8 (2), 165-178
- https://doi.org/10.1586/14737167.8.2.165
Abstract
Cost-effectiveness analyses, particularly in the USA, commonly use a figure of $50,000 per life-year or quality-adjusted life-year gained as a threshold for assessing the cost-effectiveness of an intervention. The history of this practice is ill defined, although it has been linked to the end-stage renal disease kidney dialysis cost-effectiveness literature from the 1980s. The use of $50,000 as a benchmark for assessing the cost-effectiveness of an intervention first emerged in 1992 and became widely used after 1996. The appeal of the $50,000 figure appears to lie in the convenience of a round number rather than in the value of renal dialysis. Rather than arbitrary thresholds, estimates of willingness to pay and the opportunity cost of healthcare resources are needed.Keywords
This publication has 95 references indexed in Scilit:
- Mortality-risk Valuation and Age: Stated Preference EvidenceReview of Environmental Economics and Policy, 2007
- Can we estimate the ‘social’ value of a QALY?: Four core issues to resolveHealth Policy, 2005
- Terminology I would like to see disappearAmerican Heart Journal, 1999
- Interpretation of cost-effectiveness analysesJournal of General Internal Medicine, 1998
- Relationship Between Quality of Life Instruments, Health State Utilities, and Willingness to Pay in Patients with AsthmaAnnals of Allergy, Asthma & Immunology, 1998
- Economic foundations of cost-effectiveness analysisJournal of Health Economics, 1997
- Cost-Effectiveness Analysis of Potential Improvements to Emergency Medical Services for Victims of Out-of-Hospital Cardiac ArrestAnnals of Emergency Medicine, 1996
- Cost-effectiveness ratios: in a league of their ownHealth Policy, 1994
- The utility of different health states as perceived by the general publicJournal of Chronic Diseases, 1978
- Predicting Treatment Costs and Life Expectancy for End-Stage Renal DiseaseThe New England Journal of Medicine, 1978