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Factors associated with the author-reported cost-effectiveness threshold in high-income countries: systematic review and multivariable modelling

Author

Listed:
  • Nicolas Boespflug

    (CHU Bordeaux, Service d’information Médicale, USMR & CIC-EC 1401)

  • Jérôme Wittwer

    (INSERM, Bordeaux Population Health, UMR 1219)

  • Antoine Bénard

    (CHU Bordeaux, Service d’information Médicale, USMR & CIC-EC 1401
    INSERM, Bordeaux Population Health, UMR 1219
    Université de Bordeaux)

Abstract

Objective The cost-effectiveness threshold (CET) is a key parameter to guide objective reimbursement decisions, yet very few countries have defined a reference CET, and there is no reference method for defining it. Our objective was to determine the factors explaining the author-reported CETs in the literature. Methods Our systematic review targeted original articles referenced in EMBASE and published between 2010 and 2021. Selected studies had to use Quality-Adjusted Life-Year (QALY), and being conducted in high-income countries. Our explanatory variables were: estimated cost-effectiveness ratio (ICER), region of the world, source of funding, type of intervention, disease, year of publication, justification of the author-reported Cost-Effectiveness Threshold (ar-CET), economic perspective, and declaration of interest. Multivariable linear regression models implemented on R software were used, guided by a Directed Acyclic Graph. Results Two hundred and fifty four studies were included. The mean ar-CET was €63,338/QALY (standard deviation (SD) 34,965) overall, and €37,748/QALY (SD 20,750) in studies conducted in the British Commonwealth. The ar-CET increased slightly with the ICER (+ 66€/QALY for each additional 10,000€/QALY in the ICER, 95% confidence interval (IC) [31–102], p

Suggested Citation

  • Nicolas Boespflug & Jérôme Wittwer & Antoine Bénard, 2024. "Factors associated with the author-reported cost-effectiveness threshold in high-income countries: systematic review and multivariable modelling," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(4), pages 631-639, June.
    • Handle: RePEc:spr:eujhec:v:25:y:2024:i:4:d:10.1007_s10198-023-01613-7
    DOI: 10.1007/s10198-023-01613-7
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