Abstract
New technologies may displace existing, higher‐value care under a fixed bud-get. Countries aim to curtail adoption of low‐value technologies, for example,by installing cost‐effectiveness thresholds. Our objective is to estimate theopportunity cost of hospital care to identify a threshold value for the Nether-lands. To this aim, we combine claims data, mortality data and quality of lifequestionnaires from 2012 to 2014 for 11,000 patient groups to obtain quality‐adjusted life‐year (QALY) outcomes and spending. Using a fixed effectstranslog model, we estimate that a 1% increase in hospital spending on averageincreases QALY outcomes by 0.2%. This implies a threshold of€73,600 perQALY, with 95% confidence intervals ranging from€53,000 to€94,000 perQALY. The results stipulate that new technologies with incremental cost effec-tiveness ratios exceeding the Dutch upper reference value of€80,000 mayindeed displace more valuable care.
Original language | English |
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Pages (from-to) | 1331-1344 |
Number of pages | 14 |
Journal | Health Economics |
Volume | 28 |
Issue number | 11 |
DOIs | |
Publication status | Published - 30 Aug 2019 |
Funding
We gratefully acknowledge the financial support provided by the National Health Care Institute (Zorginstituut Nederland).
Keywords
- cost-effectiveness
- health care spending
- QALY
- threshold
- translog function