Updating cost-effectiveness - the curious resilience of the $50,000-per-QALY threshold

Abstract

This article discusses the $50,000 per quality-adjusted life year (QALY) cost-effectiveness threshold, considering its origins, use, and implications for healthcare resource allocation. It argues that this threshold is arbitrary and outdated and should be replaced with multiple thresholds based on available resources and alternative uses. The authors recommend using $50,000, $100,000, and $200,000 per QALY as thresholds, with $100,000 or $150,000 as a single threshold. Ultimately, the article calls for more work to elucidate the comparative effectiveness and cost-effectiveness of existing care and to establish systemwide incentives for cost-conscious decisions. – AI-generated abstract.