Why cost-effectiveness thresholds for global health donors differ from thresholds for Ministries of Health (and why it matters)

Tom Drake, Y-Ling Chi, Alec Morton, Catherine Pitt

Research output: Contribution to journalArticlepeer-review

32 Downloads (Pure)

Abstract

Healthcare cost-effectiveness analysis is increasingly used to inform priority-setting in low- and middle-income countries and by global health donors. As part of such analyses, cost-effectiveness thresholds are commonly used to determine what is, or is not, cost-effective. Recent years have seen a shift in best practice from a rule-of-thumb 1x or 3x per capita GDP threshold towards using thresholds that, in theory, reflect the opportunity cost of new investments within a given country. In this paper, we observe that international donors face both different resource constraints and opportunity costs compared to national decision makers. Hence, their perspective on cost-effectiveness thresholds must be different. We discuss the potential implications of distinguishing between national and donor thresholds and outline broad options for how to approach setting a donor-perspective threshold. Further work is needed to clarify healthcare cost-effectiveness threshold theory in the context of international aid and to develop practical policy frameworks for implementation.

Original languageEnglish
Article number214
Number of pages10
JournalF1000Research
Volume12
Early online date27 Feb 2023
DOIs
Publication statusE-pub ahead of print - 27 Feb 2023

Keywords

  • aid
  • cost-effectiveness
  • Global health
  • health financing
  • priority-setting
  • threshold

Fingerprint

Dive into the research topics of 'Why cost-effectiveness thresholds for global health donors differ from thresholds for Ministries of Health (and why it matters)'. Together they form a unique fingerprint.

Cite this