Determination of Cost-Effectiveness Threshold For Malaysia

Abstract

for new drugs and new indications for existing drugs were identified from the European Medicines Agency (EMA) website. The decision to undertake an appraisal was obtained from the NICE website and NIHR Horizon Scanning Centre records, and the associations between this and characteristics of the drug and intended patient population were then determined. Results: For 2005-2011, we identified 134 MAs granted by the EMA (116 new drugs and 18 new indications) of which 72 (54%) were selected for appraisal. The decision to undertake an appraisal was significantly associated with an MA granted 2009-2011 (OR= 2.3, p< 0.01), the drug being a biological agent (OR= 3.9, p< 0.01), administered on a long-term basis (OR= 1.8, p< 0.05), indicated for a patient population < 1 in 1,000 (OR= 2.1, p< 0.05), or for malignant disease (OR= 5.1, p< 0.01). It was not associated with an indication for more severe disease (OR= 2.0, p= 0.06), an MA issued for a new indication (OR= 1.4, p= 0.50), or whether a drug was first-of-kind (OR= 1.8, p= 0.10). ConClusions: We identified several characteristics associated with the decision to undertake an appraisal relating to both the drug and intended patient population that do not completely match published topic selection criteria (e.g. severity). Further analyses are required to determine which are the most relevant factors in this decision.

An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran

“… Yes 670.5 348.3 399.8 Family member died in the last year (ref.no.) Yes 563.0 505.8 595.7 LR chi2 [ 14 ] 46.9 38.0 31.0 Prob > chi2 < 0.001 < 0.001 0.005 Left-censored observations 296 296 80 Uncensored observations 551 551 767 Log likelihood − 5785.2 − 5691.8 − 7543.4 Model A Dependent variable is WTP per QALY using EQ-5D-3L, Model B Dependent variable is WTP per QALY using VAS, Model C Dependent variable is WTP per QALY for family member *Significance at p < 0.05 …”

“…A recent study that estimated the CE threshold indicated the WHO recommended threshold value is considerably higher for the low-middle income countries (LMICs) [12]. Because of the limitation of the WHO recommended estimation, others applied the willingness to pay (WTP) method for a preferred attribute to estimate the CE threshold value [5,[13][14][15]. Despite methodological issues related to the use of CE threshold value approaches, there is a consensus that the different thresholds should be well defined and used for different situations such as with quality of life-improving or lifethreatening conditions.…”

An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran

“…A recent study that estimated the CE threshold using the opportunity cost indicated the WHO recommended threshold value is considerably high for the low-middle income countries (LMICs) (8). Because of the limitation of the WHO recommended estimation, others applied the willingness to pay method for a preferred attribute to estimate the CE threshold value (5,(14)(15)(16).…”

An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran

“…A recent study that estimated the CE threshold using the opportunity cost indicated the WHO recommended threshold value is considerably high for the low-middle income countries (LMICs) (12). Because of the limitation of the WHO recommended estimation, others applied the willingness to pay (WTP) method for a preferred attribute to estimate the CE threshold value (5,(13)(14)(15). However, application in healthcare systems is not well documented.…”