Evidence map›Paper›PMID 32856280›Full record

ArticlePharmacoEconomics2020

Informing a Cost-Effectiveness Threshold for Health Technology Assessment in China: A Marginal Productivity Approach.

Jessica Ochalek, Haiyin Wang, Yuanyuan Gu, James Lomas, Henry Cutler, Chunlin Jin

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Article in PharmacoEconomics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Cost Effectiveness of Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jessica Ochalek *Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK.ORCID http://orcid.org/0000-0003-0744-1178
Haiyin Wang *Shanghai Health Development Research Centre, Shanghai, 201199, China.ORCID http://orcid.org/0000-0001-9560-0460
Yuanyuan GuCentre for the Health Economy, Macquarie University, Sydney, NSW, 2109, Australia. yuanyuan.gu@mq.edu.au.ORCID http://orcid.org/0000-0002-3816-9106
James LomasCentre for Health Economics, University of York, Heslington, York, YO10 5DD, UK.ORCID http://orcid.org/0000-0002-2478-7018
Henry CutlerCentre for the Health Economy, Macquarie University, Sydney, NSW, 2109, Australia.ORCID http://orcid.org/0000-0002-6015-092X
Chunlin JinShanghai Health Development Research Centre, Shanghai, 201199, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth technology assessment has been increasingly used in China, having been legally mandated in 2019, to inform reimbursement decisions and price negotiations between the National Healthcare Security Administration and pharmaceutical companies around the price of new pharmaceuticals. The criteria currently used to judge cost effectiveness and inform pricing negotiations, 3 × GDP per capita, is based on the rule of thumb previously recommended by the World Health Organization rather than an estimate based on an empirical assessment of health opportunity costs.

objectiveThe objective of this study was to inform a cost-effectiveness threshold for health technology assessment in China that accounts for health opportunity cost.

methodsThe elasticity of health outcomes with respect to health expenditure was estimated using variations across 30 provincial-level administrative divisions in 2017 controlling for a range of other factors and using an instrumental variable approach to account for endogeneity to assess robustness of results. The estimated elasticity was then used to calculate the cost per disability-adjusted life-year (DALY) averted by variations in Chinese health expenditure at the margin.

resultsThe range estimated from this study, 27,923-52,247 (2017 RMB) (central estimate 37,446) per DALY averted or 47-88% of GDP per capita (central estimate 63%), shows that a cost per DALY averted cost-effectiveness threshold that reflects health opportunity costs is below 1 × GDP per capita.

conclusionOur results suggest that the current cost-effectiveness threshold used in China is too high; continuing to use it risks decisions that reduce overall population health.

Indexed as

Health Care CostsTechnology Assessment, BiomedicalChinaCost-Benefit AnalysisHumansQuality-Adjusted Life Years

Identifiers

PMID32856280

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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.