Using Cost-Effectiveness Thresholds to Determine Value for Money in Low- and Middle-Income Country Healthcare Systems: Are Current International Norms Fit for Purpose?

Paul Revill, Karl Claxton, Mark Sculpher, Simon Walker, Jason Madan, Andrea Ciaranello, Takondwa Mwase, Diana M. Gibb

May. 1, 2014

The population health impacts of alternative approaches to estimating cost-effectiveness thresholds, and the adverse outcomes that can result by applying aspirational notions of value (e.g. WHO recommended thresholds of 1 and 3 times GDP p.c.), are demonstrated using an example of the 2013 WHO Consolidated Guidelines on the Use of Antiretroviral Therapy. Efficient allocation of limited healthcare resources requires using these resources where they can generate greatest benefits and cost-effectiveness thresholds should reflect such assessments.

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