Report on the threshold values in health economic evaluations and decision-making published in Austria

In December 2024, the Austrian Institute for HTA published a project report titled "Threshold Values in Health Economic Evaluations and Decision-Making.” The report examined the application and implications of incremental cost-effectiveness ratio (ICER) thresholds in healthcare resource allocation across various healthcare systems. Among the 39 countries analyzed, 24 use thresholds in their decision-making processes, with values ranging from €4,000 to €50,000 per quality-adjusted life year (QALY). Most countries employ either threshold ranges or multiple baseline thresholds, often incorporating modifiers to account for considerations beyond pure health maximization.

In Austria, health economic evaluations have historically played a limited role, being formally required only in specific cases, primarily for assessing pharmaceuticals in outpatient settings. Although concepts of efficiency ("Wirtschaftlichkeit") are embedded in several laws, they are rarely operationalized in a concrete manner. The report identified key success factors for implementation, including the development of comprehensive methodological guidelines, capacity building, and raising awareness about the distinction between resource rationing and efficient utilization.

The report concluded that, despite their complexity, implementing thresholds could enhance transparency and efficiency in health systems. However, careful consideration of methodological approaches and country-specific contexts is essential.

See the details in German and English here.

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