Original Title: Valor monetario de un ańo de vida ajustado por calidad: estimación empírica del coste de oportunidad en el sistema nacional de salud

Authors' objectives: The aim of this report is to estimate the average opportunity cost of health care funding decisions in the Spanish context. This opportunity costs can be approximated by the cost per Quality-Adjusted Life Year (QALY) at which the system currently operates, and serves as a guide to set a cost-effectiveness threshold in contexts of fixed budget constraints.

Authors' results and conclusions: RESULTS: Our model estimated a positive and statistically significant effect of health expenditure on quality-adjusted life expectancy. Based on this estimation, a cost per QALY was computed in 21,000 € and 24,000 € per QALY (expressed in Euros 2012) in the Spanish NHS. CONCLUSIONS: This report offers for the first time an empirical estimation of the opportunity cost in terms of QALYs that can be used as a tool to set a cost-effectiveness threshold in Spain in the context of previously assigned budgets. The estimation is based on best evidence available but cannot be considered an exact figure. Therefore, we recommend to use a range between 20,000 € and 25,000 € as a cost-effectiveness threshold in such contexts. This figure ought to be periodically updated as new information becomes available in order to be optimally used as a reference for the cost-effectiveness threshold.

Authors' methods: The measurement of the cost per QALY requires the estimation of the impact of public health spending on population health outcomes, both in terms of mortality and morbidity. The estimation of such effect is not straightforward due to data limitations as well as for the complex nature of the relationship between both variables. We created a comprehensive database with demographic, health, socioeconomic and spending characteristics across regions (Autonomous Communities) between 2008 and 2013. We employed econometric methods using longitudinal fixed effects and instrumental variables techniques.

Project Status: Completed

Year Published: 2015

URL for published report: https://sescs.es/valor-monetario-de-un-avac-estimacion-empirica-del-coste-de-oportunidad-en-el-sns/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es