OP10 Affordability Decision Rules: Systematic Review And Categorization Of Budget Impact Thresholds For 174 Countries Based On International Practices

IntroductionEffective health intervention coverage decision-making hinges on understanding budget impact (BI). Despite progress in estimating cost-effectiveness thresholds, a standardized approach for defining BI, particularly high BI, remains elusive. Addressing this gap, our systematic review aims...

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Published in:International journal of technology assessment in health care 2025-01, Vol.40 (S1), p.S5-S5
Main Authors: Pichon-Riviere, Andres, Cairoli, Federico, Marti, Sebastian Garcia, Augustovski, Federico
Format: Article
Language:English
Subjects:
Budgets
Cost effectiveness
Decision making
Global health
Health care
Health technology assessment
Oral Presentations
Public health
Reviews
Standardization
Systematic review
Technology assessment
Thresholds
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Summary:IntroductionEffective health intervention coverage decision-making hinges on understanding budget impact (BI). Despite progress in estimating cost-effectiveness thresholds, a standardized approach for defining BI, particularly high BI, remains elusive. Addressing this gap, our systematic review aims to identify existing BI thresholds and establish universally applicable BI categories, providing a much-needed framework for global health policy.MethodsIn our systematic review, we adhered to Cochrane methods and PRISMA reporting guidelines (PROSPERO protocol CRD42020221652). We included articles that detailed current BI or affordability thresholds used by national or regional healthcare systems, sourcing from PubMed, Embase, and International Network of Agencies for Health Technology Assessment (INAHTA) communications. To address variability across jurisdictions, we normalized BI/affordability thresholds to a fraction of each country’s total healthcare expenditure. This approach enabled us to categorize BI thresholds into four distinct levels (low, moderate, high, and very high) and apply these categories universally across countries.ResultsWe retrieved 1,592 records, identifying affordability thresholds and their underlying rationales in 12 countries: Argentina, Australia, England, Canada, Germany, France, Netherlands, USA, Taiwan, Ukraine, Scotland, and Singapore. Utilizing this data, we established four BI threshold levels relative to the total health budget: low (below 0.00005), moderate (0.00005 to
ISSN:0266-4623
1471-6348
DOI:10.1017/S0266462324000746