Evaluation of the reference value of the incremental parameter "cost-effectiveness" for Russian healthcare system

Abstract

Introduction. Presently, the willingness-to-pay threshold (cost-effectiveness threshold, incremental cost-effectiveness ratio) is used as one of the decision-making criteria for reimbursement in some foreign countries with a developed system of healthcare technologies evaluation (HTE). However, in Russia, the willingness-to-pay threshold (WPT) is undetermined, which complicates the evaluation of clinical-economical effectiveness of medical technologies, including medicines.Aim. The study aimed to calculate WPT for the Russian healthcare system using the available foreign experience.Materials and Methods. WPT was calculated with the following methods: the method proposed by the WHO, hemodialysis cost-effectiveness standard, case-based reasoning (CBR), and the evaluation of the shadow cost of the budget.Results. WPT was calculated for the Russian healthcare system using four different methods of calculation. According to the method proposed by the WHO, WPT was 2,235,201.60 Rub for DALY in the RF; according to the hemodialysis cost-effectiveness standard, it was 1,748,623.36 Rub for QALY; according to the method of the evaluation of the shadow cost of the budget, it was 313,878.21 Rub for DALY and 365,060.31 Rub for QALY; and according to the method of the case-based reasoning, it was 7,494,944.00 Rub for QALY.Conclusion. The study results showed that the optimal WPT values for the Russian healthcare system were those obtained by the method of the WHO (2,235,201.60 Rub). The authors propose to use this value as one of the decision-making criteria for the reimbursement of medical technologies, including medicinal drugs.

Keywords

• cost-effectiveness threshold
• willingness-to-pay threshold
• incremental cost-effectiveness ratio
• reference value of the icer
• quality-adjusted life years qaly
• life years gained
• lyg
• disability-adjusted life year
• daly