EE5 THE SEESAW OF COST-EFFECTIVENESS THRESHOLDS: HOW RELAXED REQUIREMENTS FOR LATER LINES OF TREATMENT WILL INCREASE HURDLES FOR NEW THERAPIES

  • Liwing J
  • Lothgren M
N/ACitations
Citations of this article
5Readers
Mendeley users who have this article in their library.

Abstract

OBJECTIVES: This analysis investigates the implicit cost-effectiveness requirements for new therapies used earlier in a treatment sequence when cost-effectiveness thresh-olds have been relaxed for for later lines of therapies. Two examples of this are: 1) The National Institute for Health and Clinical Excellence (NICE) decision to allow higher cost-effectiveness thresholds for later lines of therapy in certain oncology indi-cations, and 2) The Swedish Dental and Pharmaceutical Benefits Board (TLV) implicit decisions to accept higher thresholds with later line restrictions. METHODS: A simple example is constructed where a new competing 1st line therapy (A) can replace the currently used therapy (B). It is assumed that if no further lines of therapy exists then therapy A would be considered cost-effective compared to B using a formal threshold level of T. A third therapy (C) is approved to be used only in 2nd line therapy and is accepted at a higher cost-effectiveness threshold than T. The problem is focused on the formal evaluation of the incremental cost-effectiveness ratio of the new therapy A vs. B in the presence of therapy C. RESULTS: The implication of relaxing the cost-effectiveness requirement for later lines of therapies is a further strengthening of the requirement of new therapies for earlier use in treatment sequences. In the most extreme scenario a new therapy, with less cost and higher effectiveness compared to standard therapy in a specific line, may not be considered cost-effective. CONCLU-SIONS: This increased implicit cost-effectiveness threshold by the new regulations may risk crowding-out of new cost-effective therapies in earlier lines unless the explicit requirements/thresholds are modified using the highest accepted ratio between the costs and efficacy in the treatment sequence. Another solution is to evaluate and compare complete treatment sequences.

Cite

CITATION STYLE

APA

Liwing, J., & Lothgren, M. (2009). EE5 THE SEESAW OF COST-EFFECTIVENESS THRESHOLDS: HOW RELAXED REQUIREMENTS FOR LATER LINES OF TREATMENT WILL INCREASE HURDLES FOR NEW THERAPIES. Value in Health, 12(7), A230. https://doi.org/10.1016/s1098-3015(10)74120-6

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free