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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


GARCIA-LORENZO, Borja et al. Economic evaluation seeks threshold to support decision-making. Rev. Esp. Salud Publica [online]. 2015, vol.89, n.6, pp.537-544. ISSN 2173-9110.

To incorporate economic evaluation into decision-making, we need to know how much a health system is willing and able to invest in a quality-adjusted life year (QALY). In Spain, the figure of €30,000 per QALY as cost-effectiveness (CE) threshold has been widely cited. However, as in most health systems, no value has been formally adopted; mainly because of the arbitrariness, the lack of theoretical and scientific basis, and the controversy around its estimation and what the threshold should represent. Based on a systematic review of empirical studies on the estimation of the CE threshold undertaken by this research team, we conducted a critical appraisal of the state of the art, using a Delphi with the participation of 13 national experts. This paper contributes to assess the research progress on the CE threshold in Spain, to consider its utility in the decision making process supported by economic evaluation, and to propose further research to improve what has been achieved so far.

Keywords : Quality-Adjusted Life Year; Economic evaluation; Health technology assessment; Spain.

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