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KMID : 1170320220280020129
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Korean Journal of Health Economics and Policy
2022 Volume.28 No. 2 p.129 ~ p.156
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A systematic review of studies estimating opportunity cost-based cost-effectiveness thresholds
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Hong Ji-Hyung
Bae Eun-Young
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Abstract
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A cost-effectiveness threshold is required when deciding whether a new healthcare technology is too expensive. There are generally two perspectives on what a cost-effectiveness threshold should reflect. A demand-side approach emphasizes the consumption value of health, whereas a supply-side approach emphasizes the opportunity costs of funding decisions. In recent years, there has been growing attention on the opportunity cost-based threshold, especially with the rise of high-cost healthcare technologies. This study, therefore, conducted a systematic review of studies estimating the opportunity cost-based thresholds. A total of 17 studies were included in this review, of which 14 conducted country-specific analyses. These studies generally estimated the marginal cost per unit of health produced within the health care system. Threshold estimates were relatively lower in the UK, Australia, and other upper-middle-income countries such as China and Colombia than in the United States and Nordic countries, which were well below the GDP per capita. In addition, methodological approaches taken in the included studies were thoroughly reviewed and analyzed to derive methodological implications and insights. These findings, together with the local context and the type of data available, should be fully taken into account when estimating one such threshold in Korea.
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KEYWORD
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cost-effectiveness threshold, ICER, opportunity costs, marginal productivity
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