Updating Cost-Effectiveness — The Curious Resilience of the $50,000-per-QALY Threshold

• Published in: The New England journal of medicine Vol. 371; no. 9; pp. 796 - 797
• Main Authors: Neumann, Peter J, Cohen, Joshua T, Weinstein, Milton C
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 28.08.2014
• Subjects: Cost-Benefit Analysis; Health care; Health Care Costs; Health care expenditures; Health care policy; Health Policy - economics; Humans; Medicare; Models, Economic; Quality of life; Quality-Adjusted Life Years; Ratios; United States; United States; United States > US
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMp1405158

The ratio of $50,000 per quality-adjusted life-year (QALY) gained by using a given health care intervention has long served as a benchmark for the value of U.S. health care. But evidence suggests that it is too low and might best be thought of as an implied lower boundary. For more than two decades, the ratio of $50,000 per quality-adjusted life-year (QALY) gained by using a given health care intervention has played an important if enigmatic role in health policy circles as a benchmark for the value of care. Researchers have summoned this cost-effectiveness ratio in order to champion or denounce particular investments in medical technologies and health programs. Critics, meanwhile, have argued that the ratio is misunderstood and misused. The fact that the $50,000-per-QALY yardstick has persisted attests to the medical community's need for a value threshold and to the advantages enjoyed by incumbents. It has endured even . . .