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

Int J Environ Res Public Health. 2010 Apr;7(4):1831-4. doi: 10.3390/ijerph7041831. Epub 2010 Apr 20.


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.

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

Publication types

  • Comment

MeSH terms

  • Cost-Benefit Analysis*
  • Drug Costs
  • Health Care Costs*
  • New Zealand
  • Quality-Adjusted Life Years