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The marginal benefits of healthcare spending in the Netherlands: Estimating cost‐effectiveness thresholds using a translog production function

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  • Niek Stadhouders
  • Xander Koolman
  • Christel van Dijk
  • Patrick Jeurissen
  • Eddy Adang

Abstract

New technologies may displace existing, higher‐value care under a fixed budget. Countries aim to curtail adoption of low‐value technologies, for example, by installing cost‐effectiveness thresholds. Our objective is to estimate the opportunity cost of hospital care to identify a threshold value for the Netherlands. To this aim, we combine claims data, mortality data and quality of life questionnaires from 2012 to 2014 for 11,000 patient groups to obtain quality‐adjusted life‐year (QALY) outcomes and spending. Using a fixed effects translog model, we estimate that a 1% increase in hospital spending on average increases QALY outcomes by 0.2%. This implies a threshold of €73,600 per QALY, with 95% confidence intervals ranging from €53,000 to €94,000 per QALY. The results stipulate that new technologies with incremental cost effectiveness ratios exceeding the Dutch upper reference value of €80,000 may indeed displace more valuable care.

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  • Niek Stadhouders & Xander Koolman & Christel van Dijk & Patrick Jeurissen & Eddy Adang, 2019. "The marginal benefits of healthcare spending in the Netherlands: Estimating cost‐effectiveness thresholds using a translog production function," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1331-1344, November.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:11:p:1331-1344
    DOI: 10.1002/hec.3946
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    1. Opportunity costs, marginal productivity, and cost-effectiveness thresholds: what are they and how are they related?
      by Rita Faria, Jessica Ochalek, jameslomas88 in The Academic Health Economists' Blog on 2020-09-23 06:00:00

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    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. Bruno Wichmann & Roberta Wichmann, 2020. "Nonparametric estimation of a primary care production function in urban Brazil," Health Economics Review, Springer, vol. 10(1), pages 1-10, December.
    4. Siverskog, Jonathan & Henriksson, Martin, 2022. "The health cost of reducing hospital bed capacity," Social Science & Medicine, Elsevier, vol. 313(C).
    5. Karanfil, Fatih & Pierru, Axel, 2021. "The opportunity cost of domestic oil consumption for an oil exporter: Illustration for Saudi Arabia," Energy Economics, Elsevier, vol. 96(C).

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