Estimating a cost‐effectiveness threshold for the Spanish NHS

Laura Vallejo‐Torres; Borja García‐Lorenzo; Pedro Serrano‐Aguilar

doi:10.1002/hec.3633

journal article Dec 28, 2017

Estimating a cost‐effectiveness threshold for the Spanish NHS

Laura Vallejo‐Torres

Borja García‐Lorenzo Pedro Serrano‐Aguilar

Health Economics Vol. 27 No. 4 pp. 746-761 · Wiley

View at Publisher Save 10.1002/hec.3633

Abstract

AbstractThe cost of generating a quality‐adjusted life year (QALY) within a National Health Service provides an approximation of the average opportunity cost of funding decisions. This information can be used to inform a cost‐effectiveness threshold. The aim of this paper is to estimate the cost per QALY at the Spanish National Health Service. We exploit variation across 17 regional health services and the exogenous changes in expenditure that took place as a consequence of the economic crisis over 5 years of data. We conduct fixed effect models and use an instrumental variable approach to test for potential remaining endogeneity. Our results show that health expenditure has a positive and significant effect on population health, with an average spending elasticity of 0.07. This translates into a cost per QALY of between 22,000€ and 25,000€. These values are below the cost‐effectiveness threshold figure of 30,000€ commonly cited in Spain.

Topics

No keywords indexed for this article. Browse by subject →

References

21

[1]

Abellán Perpiñán J. M. Martínez Pérez J. E. Méndez Martínez I. Sánchez Martínez F. I. Pinto Prades J. L. Robles Zurita J. A. (2011).El valor monetario de una víctima no mortal y del año de vida ajustado por calidad en España. Dirección General de Tráfico. Available from:http://www.dgt.es/Galerias/seguridad‐vial/investigacion/estudios‐e‐informes/2011/SPAD1A_‐.‐ESTIMACION‐EN‐EL‐CONTEXTO‐DE‐LOS‐ACCIDENTES‐DE‐TRAFICO_INFORME‐PARA‐WEB.pdf.

[2]

10.1017/s1744133111000181

[3]

10.3310/hta19140

[4]

Davidson R. (1993)

[5]

De la Fuente A.(2015).El cálculo de las necesidades de gasto regionales: notas para la discusión.Fedea Policy Papers2015/07. Available from:http://www.fedea.net/documentos/pubs/fpp/2015/10/FPP2015‐07.pdf

[6]

Donaldson C. Baker R. Mason H. Pennington M. Bell S. Lancsar E. …Shackley P.(2010).European Value of a Quality Adjusted Life Year. Available from:http://research.ncl.ac.uk/eurovaq/EuroVaQ_Final_Publishable_Report_and_Appendices.pdf

[7]

European Commission Commission services (Directorate‐General for Economic and Financial Affairs) Economic Policy Committee (Ageing Working Group). (2016).Joint report on health care and long‐term care systems & fiscal sustainability. Institutional Paper 37 Volume 2‐ Country Documents. Available from:https://ec.europa.eu/info/sites/info/files/file_import/joint‐report_es_en_2.pdf

[8]

Gallet C. A. &Doucouliagos C. (2015).The impact of healthcare spending on health outcomes: A meta‐regression analysis. Economics Series SWP 2015/11. Available from:https://www.deakin.edu.au/__data/assets/pdf_file/0006/429288/2015_11‐1.pdf

[9]

10.1016/j.healthpol.2013.06.016

[10]

Gaminde I. &Roset M. (2001).Quality adjusted life expectancy. In: Discussion papers/17th Plenary Meeting of the Euroqol Group. Available from:https://www.researchgate.net/profile/Idoia_Gaminde/publication/228396006_Quality_adjusted_life_expectancy/links/02bfe50ceea75ba6ba000000.pdf

[11]

García‐Lorenzo B. "Economic evaluation seeks threshold to support decision‐making" Revista Española de Salud Pública (2015)

[12]

10.1016/j.qref.2004.05.005

[13]

10.1002/hec.1716

[14]

10.1016/j.jhealeco.2007.12.002

[15]

10.1186/1472-6963-14-287

[16]

10.1016/j.jhealeco.2009.02.003

[17]

Puig‐Junoy J. &Merino‐Castelló A. (2004).Productividad marginal del gasto e innovaciones sanitarias. Resultados empíricos y lecciones para España. In Masson ed. ¿Más recursos para la salud?

[18]

10.1016/s0213-9111(02)71933-x

[19]

10.3368/jhr.50.2.301

[20]

10.2307/4594169

[21]

10.1016/j.jval.2016.02.020

Cited By

247

On the role of cost-effectiveness thresholds in healthcare priority setting

Jonathan Siverskog, Martin Henriksson · 2021

International Journal of Technology...

When is it too expensive? Cost-effectiveness thresholds and health care decision-making

Werner Brouwer, Pieter van Baal · 2018

The European Journal of Health Econ...

Metrics

247

Citations

21

References

Details

Published: Dec 28, 2017
Vol/Issue: 27(4)
Pages: 746-761
License: View

Authors

L

Laura Vallejo‐Torres

Canary Islands Health Research Foundation (FUNCANIS) Tenerife Canary Islands Spain; Department of Quantitative Methods in Economics and Management University of Las Palmas de Gran Canaria Las Palmas Canary Islands Spain; Spanish Network of Health Technology and Performance Assessment Madrid Spain

B

Borja García‐Lorenzo

Canary Islands Health Research Foundation (FUNCANIS) Tenerife Canary Islands Spain; Universistat Internacional de Catalunya Barcelona Spain

P

Pedro Serrano‐Aguilar

Canary Islands Health Research Foundation (FUNCANIS) Tenerife Canary Islands Spain; Spanish Network of Health Technology and Performance Assessment Madrid Spain; Servicio de Evaluación del Servicio Canario de la Salud (SESCS) Santa Cruz de Tenerife Canary Islands Spain

Cite This Article

Laura Vallejo‐Torres, Borja García‐Lorenzo, Pedro Serrano‐Aguilar (2017). Estimating a cost‐effectiveness threshold for the Spanish NHS. Health Economics, 27(4), 746-761. https://doi.org/10.1002/hec.3633

Estimating a cost‐effectiveness threshold for the Spanish NHS

You May Also Like