Systematic review of the impact of health care expenditure on health outcome measures: implications for cost-effectiveness thresholds
Issued Date
2024-01-01
Resource Type
ISSN
14737167
eISSN
17448379
Scopus ID
2-s2.0-85180882369
Pubmed ID
38112068
Journal Title
Expert Review of Pharmacoeconomics and Outcomes Research
Volume
24
Issue
2
Start Page
203
End Page
215
Rights Holder(s)
SCOPUS
Bibliographic Citation
Expert Review of Pharmacoeconomics and Outcomes Research Vol.24 No.2 (2024) , 203-215
Suggested Citation
Gloria M.A.J., Thavorncharoensap M., Chaikledkaew U., Youngkong S., Thakkinstian A., Chaiyakunapruk N., Ochalek J., Culyer A.J. Systematic review of the impact of health care expenditure on health outcome measures: implications for cost-effectiveness thresholds. Expert Review of Pharmacoeconomics and Outcomes Research Vol.24 No.2 (2024) , 203-215. 215. doi:10.1080/14737167.2023.2296562 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/96006
Title
Systematic review of the impact of health care expenditure on health outcome measures: implications for cost-effectiveness thresholds
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective: Empirical estimates of the impact of healthcare expenditure on health outcome measures may inform the cost-effectiveness threshold (CET) for guiding funding decisions. This study aims to systematically review studies that estimated this, summarize and compare the estimates by country income level. Methods: We searched PubMed, Scopus, York Research database, and [anonymized] for Reviews and Dissemination database from inception to 1 August 2023. For inclusion, a study had to be an original article, estimating the impact of healthcare expenditure on health outcome measures at a country level, and presented estimates, in terms of cost per quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Results: We included 18 studies with 385 estimates. The median (range) estimates were PPP$ 11,224 (PPP$ 223–PPP$ 288,816) per QALY gained and PPP$ 5,963 (PPP$ 71–PPP$ 165,629) per DALY averted. As ratios of Gross Domestic Product per capita (GDPPC), these estimates were 0.376 (0.041–182.840) and 0.318 (0.004–37.315) times of GDPPC, respectively. Conclusions: The commonly used CET of GDPPC seems to be too high for all countries, but especially low-to-middle-income countries where the potential health losses from misallocation of the same money are greater. Registration: The review protocol was published and registered in PROSPERO (CRD42020147276).