Santos André Soares, Guerra-Junior Augusto Afonso, Godman Brian, Morton Alec, Ruas Cristina Mariano
a Department of Social Pharmacy, College of Pharmacy , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil.
b SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), College of Pharmacy , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil.
Expert Rev Pharmacoecon Outcomes Res. 2018 Jun;18(3):277-288. doi: 10.1080/14737167.2018.1443810. Epub 2018 Feb 27.
Cost-effectiveness thresholds (CETs) are used to judge if an intervention represents sufficient value for money to merit adoption in healthcare systems. The study was motivated by the Brazilian context of HTA, where meetings are being conducted to decide on the definition of a threshold.
An electronic search was conducted on Medline (via PubMed), Lilacs (via BVS) and ScienceDirect followed by a complementary search of references of included studies, Google Scholar and conference abstracts. Cost-effectiveness thresholds are usually calculated through three different approaches: the willingness-to-pay, representative of welfare economics; the precedent method, based on the value of an already funded technology; and the opportunity cost method, which links the threshold to the volume of health displaced. An explicit threshold has never been formally adopted in most places. Some countries have defined thresholds, with some flexibility to consider other factors. An implicit threshold could be determined by research of funded cases.
CETs have had an important role as a 'bridging concept' between the world of academic research and the 'real world' of healthcare prioritization. The definition of a cost-effectiveness threshold is paramount for the construction of a transparent and efficient Health Technology Assessment system.
成本效益阈值（CETs）用于判断一项干预措施是否具有足够的性价比，从而值得在医疗保健系统中采用。该研究是受巴西卫生技术评估（HTA）背景的推动，目前正在召开会议以决定阈值的定义。
对Medline（通过PubMed）、Lilacs（通过BVS）和ScienceDirect进行了电子检索，随后对纳入研究的参考文献、谷歌学术和会议摘要进行了补充检索。成本效益阈值通常通过三种不同方法计算：代表福利经济学的支付意愿法；基于已获资助技术价值的先例法；以及将阈值与健康替代量联系起来的机会成本法。在大多数地方，明确的阈值从未被正式采用过。一些国家已经定义了阈值，并在考虑其他因素时有一定灵活性。隐性阈值可以通过对已获资助案例的研究来确定。
成本效益阈值作为学术研究领域与医疗保健优先排序“现实世界”之间的“桥梁概念”发挥了重要作用。成本效益阈值的定义对于构建透明且高效的卫生技术评估系统至关重要。
