THEORETICAL APPROACHES TO DETERMINING THE WILLINGNESS-TO-PAY THRESHOLD FOR HEALTH TECHNOLOGIES

DOI: https://doi.org/10.29296/25419218-2018-08-02
Issue: 
8
Year: 
2018

T.P. Bezdenezhnykh(1), V.V. Omelyanovsky(1−3), N.Z. Musina(1−4), V.K. Fedyaeva(1−3), T.S. Teptsova(1,4) 1-Center of Healthcare Expertise and Quality Control, Ministry of Health of Russia, 10, Khokhlovsky lane, Build. 5, Moscow 109028, Russian Federation; 2-Finance Research Institute, Ministry of Finance of the Russian Federation, 3, Nastasyinsky Lane, Build. 2, Moscow 127006, Russian Federation; 3-Russian Presidential Academy of National Economy and Public Administration, 84, Vernadsky Prospect, Build. 2, Moscow 119571, Russian Federation; 4-I.M. Sechenov First Moscow State Medical University (Sechenov University), 8, Trubetskaya St., Moscow119991, Russia

The paper reviews existing approaches to determining the willingness-to-pay threshold (WTPT), the incremental cost-effectiveness threshold, and the reference value of the incremental cost-effectiveness ratio (ICER). It analyzes the existing approaches to determining WTPT, such as construction of ranking tables, analysis of previously made decisions, WHO methodology based on the country’s three-fold per-capita gross domestic product (GDP), as well as two empirical approaches to measuring WTPT in terms of supply and demand. None of the approaches is universal and their application depends on the context of the health system as a whole. WTPT is applicable only in case of uniformity of the methodology of clinical and economic studies. WTPT is not the only criterion for decision-making in any country. Medical technologies with WTPT above the recommended value can be approved on the basis of non-economic benefits (the rarity and severity of a disease, the significant prolongation of life and the improvement of its quality, ethical considerations and equality of access to healthcare)

Keywords: 
incremental cost-effectiveness threshold
willingness-to-pay threshold
one year of life saved
one year of quality-adjusted life saved
incremental cost-effectiveness ratio (ICER)
threshold
reference value of ICER
quality-adjusted life year (QALY)
life year gained (LYG)

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