25 January 2021 - In the past few years, empirical estimates of the marginal cost at which health care produces a quality adjusted life year (QALY) have begun to emerge. 

In theory, these estimates could be used as cost-effectiveness thresholds by health maximising decision makers, but prioritisation decisions in practice often include other considerations than just efficiency.

Pharmaceutical reimbursement in Sweden is one such example, where the reimbursement authority (TLV) uses a threshold range to give priority to disease severity and rarity.

Read International Journal of Technology Assessment in Health Care article