Methods Of Cost-Effectiveness Threshold Determination And Application In Pharmacoeconomics Evaluation

Almost every country in worldwide had been faced or is facing the dilemma of roaring budget in health care and the unreasonable expenditure structure of health care as well as excessive high percent of drug fees, so reasonable health care resource allocation decision making is required. Furthermore, pharmacoeconomics evaluation is a proved effective tool which can help to optimize the health care resource allocations. It plays an important role in health care decision-making process of increasing number countries. Pharmacoeconomics has been introduced into China for almost20years, but it has not been used widely till now. There are several reasons, such as the lack of government’s impulse, faultiness of Pharmacoeconomics evaluation in China, especially the lack of Pharmacoeconomics evaluation criterion.Cost-effectiveness analysis and cost-utility analysis are the two main methods of Pharmacoeconomics evaluation, in contrast with endogenetic evaluation criterion "1" of cost-benefit analysis, these two methods have no endogenetic evaluation standard, hence, the exogenous evaluation standard---cost-effectiveness threshold is needed, it is the key to determine whether these two methods can be used from theory to practice. At present, there is not any authority issued cost-effectiveness threshold and seldom methods to identify cost-effectiveness threshold either in our country. Although some researches can be found about other countries, totally indiscriminately imitate the results is inappropriate.Using theoretical research and comparative analysis methods, our research focus on the following issues:firstly, clarify the theoretical and practice meaning of cost-effectiveness threshold; secondly, introduce the unit, definition and characters of threshold, complete the definition, choose the best unit and characters; thirdly, determine the confirming principles and the influence factors of the cost-effectiveness threshold from government decision maker; fourthly, explore the advantages, disadvantages and application conditions of the existing confirming methods of cost-effectiveness threshold; fifthly, explore the further details of whether the existing confirming methods of cost-effectiveness threshold are suitable to our reality conditions should be revealed; sixth, analyze the application of cost-effectiveness threshold, propose a new decision making model based cost-effectiveness threshold.Through the above research, we provide the theories and methods to confirm the cost-effectiveness threshold in our country, and put forth effort to construct the determining methods which can be adjusted according to the changes of the influence factors and the specific conditions, analyze the correlative application of cost-effectiveness threshold. The results of our research may help to expand the application of cost-effectiveness analysis and cost-utility analysis in our country. We also believe this research can be tapping the research and application of Pharmacoeconomics in China from theory to practice, with a great theoretical and practice meaning on Pharmacoeconomics and its application in decision making of health care.