ArticlePharmacoEconomics2015
Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness.
Article in PharmacoEconomics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- Revealed and Stated Preferences of Decision Makers for Priority Setting in Health Technology Assessment: A Systematic Review.PharmacoEconomics · 2018Pooled it
- Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Pooled it
- Prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM): a cost-effectiveness analysis comparing team-based rehabilitation in primary care vs treatment as usual.BMC health services research · 2026Trial
- Cost-Effectiveness of App-Guided Self-Management for Posttraumatic Stress: Trial-Based Economic Evaluation.Journal of medical Internet research · 2025Trial
- Internet-Delivered Exposure and Response Prevention for Pediatric Tourette Syndrome: 12-Month Follow-Up of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Cost-effectiveness of ticagrelor in patients with type 2 diabetes and coronary artery disease: a European economic evaluation of the THEMIS trial.European heart journal. Cardiovascular pharmacotherapy · 2022Trial
- Therapist-Supported Internet-Delivered Exposure and Response Prevention for Children and Adolescents With Tourette Syndrome: A Randomized Clinical Trial.JAMA network open · 2022Trial
- The Cost-Effectiveness of Lorlatinib Versus Chemotherapy as a Second- or Third-Line Treatment in Anaplastic Lymphoma Kinase (ALK)-Positive Non-small-cell Lung Cancer in Sweden.PharmacoEconomics · 2021Trial
- Cost-effectiveness of internet-delivered cognitive-behavioural therapy for adolescents with irritable bowel syndrome.BMJ open · 2019Trial
- Cost-effectiveness analysis of parenting interventions for the prevention of behaviour problems in children.PloS one · 2019Trial
- Double Threshold Prioritarianism - Some Problems and Solutions.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Severity and Temporality in Healthcare Priority Setting - A Case for A Condition-specific Affectable Time-neutral Approach.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Influence of clinical benefit and cost-effectiveness on reimbursement decisions for lung cancer drugs in Spain.Cost effectiveness and resource allocation : C/E · 2026Article
- Informing decisions in light of parameter uncertainty - an economic evaluation of the adjuvanted recombinant herpes zoster vaccine in Sweden.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Evaluating the cost-effectiveness of Everyday Life Rehabilitation (ELR) for individuals with serious mental illness in supported accommodation.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Severity as a Criterion for Prioritizing Diagnostic Measures.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Cost-effectiveness Analysis Comparing Osia System to Percutaneous Bone Conduction Devices in Sweden.Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026Article
- Optimizing Prehospital Acute Transfer of Patients With Presumed Stroke Given Economic Constraints.European journal of neurology · 2025Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe Swedish Dental and Pharmaceutical Benefits Agency (TLV) is the government body responsible for deciding whether outpatient drugs are to be included in the pharmaceutical benefits scheme. This paper analyzes the impact of cost effectiveness and severity of disease on reimbursement decisions for new pharmaceuticals.
methodsData has been extracted from all decisions made by the TLV between 2005 and 2011. Cost effectiveness is measured as the cost per quality-adjusted life-year (QALY) gained, whereas disease severity is a binary variable (severe-not severe). In total, the dataset consists of 102 decisions, with 86 approved and 16 declined reimbursements.
resultsThe lowest cost per QALY of declined reimbursements is Swedish kronor (SEK) 700,000 (€ 79,100), while the highest cost per QALY of approved reimbursements is SEK1,220,000 (€ 135,600). At a cost per QALY of SEK702,000 Swedish kronor (non-severe diseases) and SEK988,000 (severe diseases), the likelihood of approval is estimated to be 50/50 (€ 79,400 and € 111,700).
conclusionsThe TLV places substantial weight on both the cost effectiveness and the severity of disease in reimbursement decisions, and the implied willingness to pay for a QALY is higher than the often cited 'rule of thumb' in Swedish policy debates.
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26093889What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.