Comments on ※Simoens, S. Health Economic Assessment: A Methodological Primer. Int. J. Environ. Res. Public Health 2009, 6, 2950-2966§〞New Zealand in Fact Has No Cost-Effectiveness Threshold

作者：Scott Metcalfe; Rachel Grocott

来源：International Journal of Environmental Research and Public Health, 2010.

DOI：10.3390/ijerph7041831

• decision making
• prioritisation
• health economic evaluation and technology assessment
• pharmaceutical costs
• budget impact analysis
• opportunity cost
• cost-effectiveness threshold
• cost savings
• cost-benefit analysis
• quality-adjusted life years

The Journal recently incorrectly ascribed cost-effectiveness thresholds to New Zealand, alongside other countries. New Zealand has no such thresholds when deciding the funding of pharmaceuticals. As we fund pharmaceuticals within a fixed budget, and cost-effectiveness is only one of nine decision criteria used to inform decisions, thresholds cannot be inferred or calculated. Thresholds inadequately account for opportunity cost and affordability, and are incompatible with budgets and maximising health gains. In New Zealand, pharmaceutical investments can only be considered ＆cost-effective＊ when prioritised against other proposals at the time, and threshold levels must inevitably vary with available funds and the other criteria.