Understanding and improving the one and three times GDP per capita cost-effectiveness thresholds
Understanding and improving the one and three times GDP per capita cost-effectiveness thresholds
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DOI：
10.1093/heapol/czw096
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发表时间：
2017-02-01
影响因子：
3.2
通讯作者：
Resch, Stephen
中科院分区：
文献类型：
--
作者：
Robinson, Lisa A.;Hammitt, James K.;Resch, Stephen
研究人员和政策制定者长期以来一直对制定简单的决策规则感兴趣，以帮助确定干预措施是否具有成本效益。在全球卫生领域，每残疾调整生命年所花费的干预措施所避免的成本分别低于人均国内生产总值的三倍和一倍，通常被认为具有成本效益和非常具有成本效益。本文探讨了这些阈值的概念基础和推导。其目标是促进对这些阈值的产生方式及其影响的理解，并提出改进方案。这些阈值旨在根据受影响个人对健康支出与其他商品和服务支出的偏好，反映其福利的货币价值。然而，目前的数值并不是严格推导得出的，这意味着它们的应用可能会导致关于应采取哪些干预措施以及卫生和其他投资之间的资源分配不当的不适当结论。鉴于可用资源有限且人民需求巨大，改善这些成本效益阈值的基础对于低收入和中等收入国家尤为重要。
Researchers and policymakers have long been interested in developing simple decision rules to aid in determining whether an intervention is, or is not, cost-effective. In global health, interventions that impose costs per disability-adjusted life year averted less than three and one times gross domestic product per capita are often considered cost-effective and very cost-effective, respectively. This article explores the conceptual foundation and derivation of these thresholds. Its goal is to promote understanding of how these thresholds were derived and their implications, as well as to suggest options for improvement. These thresholds are intended to reflect the monetary value of the benefits to affected individuals, based on their preferences for spending on health vs spending on other goods and services. However, the current values were not rigorously derived, which means that their application may lead to inappropriate conclusions regarding which interventions should be adopted as well as misallocation of resources across health and other investments. Improving the basis for these cost-effectiveness thresholds is of particular importance in low-and middle-income countries, given the limited resources available and the significant needs of their populations.