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Should Hungary Pay More for a QALY Gain than Higher-Income Western European Countries?

Author

Listed:
  • Sándor Kovács

    (University of Pécs
    Syreon Research Institute)

  • Bertalan Németh

    (Syreon Research Institute)

  • Dalma Erdősi

    (University of Pécs)

  • Valentin Brodszky

    (Corvinus University of Budapest)

  • Imre Boncz

    (Institute for Health Insurance, Faculty of Health Sciences, University of Pécs)

  • Zoltán Kaló

    (Syreon Research Institute
    Centre for Health Technology Assessment, Semmelweis University)

  • Antal Zemplényi

    (University of Pécs
    Syreon Research Institute)

Abstract

Objectives Cost-effectiveness thresholds (CETs) play a particularly important role in the reimbursement decisions of health technologies in countries with limited healthcare resources. Our goal is to develop a scientifically solid proposal for a revised cost-effectiveness threshold, as part of the planned review of the Hungarian health economic guidance. Methods The Threshold Working Group of the Hungarian Health Economics Association performed a targeted review on CETs in European countries. International trends on CETs served as a basis for our recommendation, which was discussed at the Association’s workshop and deliberated at an expert committee meeting with representatives from the national health technology assessment (HTA) and healthcare payer bodies, and academic HTA centres. Results The current Hungarian CET is one of the highest among European countries relative to GDP per capita, and even higher in nominal value than the CET applied by NICE. As opposed to the current, single Hungarian threshold, other European countries apply multiple thresholds. The Working Group recommends that Hungary should also apply multiple CETs in the range of 1.5–3 times GDP per capita with stratification according to the relative quality-adjusted life-year (QALY) gain of the new technology. In addition, multiple CETs in the range of 3–10 times GDP per capita is recommended for technologies in rare diseases. Conclusions CETs should be aligned with the country’s economic performance and should reflect societal preferences. Our recommendation may increase the efficiency of healthcare resource allocation in Hungary by strengthening the role of HTA in the reimbursement decisions and favouring new technologies with higher QALY gain.

Suggested Citation

  • Sándor Kovács & Bertalan Németh & Dalma Erdősi & Valentin Brodszky & Imre Boncz & Zoltán Kaló & Antal Zemplényi, 2022. "Should Hungary Pay More for a QALY Gain than Higher-Income Western European Countries?," Applied Health Economics and Health Policy, Springer, vol. 20(3), pages 291-303, May.
  • Handle: RePEc:spr:aphecp:v:20:y:2022:i:3:d:10.1007_s40258-021-00710-z
    DOI: 10.1007/s40258-021-00710-z
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    References listed on IDEAS

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    1. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions – reply to Richardson and Shiell," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 261-263, April.
    2. Reckers-Droog, V.T. & van Exel, N.J.A. & Brouwer, W.B.F., 2018. "Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands," Health Policy, Elsevier, vol. 122(6), pages 621-629.
    3. Aki Tsuchiya & Paul Dolan, 2009. "Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 147-159, February.
    4. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    5. Stolk, Elly A. & Pickee, Stefan J. & Ament, Andre H.J.A. & Busschbach, Jan J.V., 2005. "Equity in health care prioritisation: An empirical inquiry into social value," Health Policy, Elsevier, vol. 74(3), pages 343-355, November.
    6. Cookson, Richard & Drummond, Mike & Weatherly, Helen, 2009. "Explicit incorporation of equity considerations into economic evaluation of public health interventions," Health Economics, Policy and Law, Cambridge University Press, vol. 4(2), pages 231-245, April.
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