Hungarian relative-QALY-gain stratified cost-effectiveness threshold framework (1.5-3x GDP)
This method proposes a new way for Hungary to decide which health treatments are worth funding by linking the cost-effectiveness threshold to the country's income level and how much health benefit (measured in QALYs) a treatment provides. Instead of using one fixed threshold, it suggests using different thresholds based on how much better a new treatment is compared to existing ones.
At a glance
Use when
Making health technology reimbursement decisions in Hungary; updating national HTA guidelines; evaluating treatments with varying levels of clinical benefit
Avoid when
In settings with rigid budget constraints that cannot accommodate variable thresholds; when reliable QALY gain estimates are unavailable; outside the Hungarian healthcare context without local validation
Inputs
GDP per capita, relative QALY gain of new technology vs. current standard, disease rarity status
Outputs
Stratified cost-effectiveness threshold (1.5–3x or 3–10x GDP per capita) for reimbursement decision-making
How it works
The framework recommends a stratified cost-effectiveness threshold (CET) for Hungary ranging from 1.5 to 3 times GDP per capita, adjusted according to the relative QALY gain of a new health technology compared to current standards. For rare diseases, a higher range of 3–10 times GDP per capita is proposed. The method is based on a targeted review of European CET practices, expert consensus, and alignment with national economic capacity and societal preferences. It aims to improve resource allocation efficiency in reimbursement decisions.
- HTA domains
- Clinical Effectiveness, Costs & Economic Evaluation
- Assumptions
- Societal willingness to pay increases with greater relative health gains; economic capacity should guide threshold levels; higher thresholds for rare diseases reflect societal preferences and unmet need
- Strengths
- Aligns thresholds with national income and European practices,Differentiates between incremental health gains, promoting value-based pricing,Introduces flexibility through stratification, improving decision-making nuance,Developed through expert consensus involving HTA bodies, payers, and academics
- Limitations
- Relies on accurate estimation of relative QALY gains, which may be uncertain in practice,Does not specify exact thresholds within the 1.5–3x range for each stratum,May be challenging to implement without clear guidance on defining 'relative QALY gain',Higher thresholds for rare diseases may strain limited healthcare budgets
- Also known as
- Hungarian stratified CET framework, Relative-QALY gain-based CET framework, Hungarian GDP-based cost-effectiveness threshold
Questions this answers
- › What cost-effectiveness threshold should Hungary use for health technology reimbursement?
- › How should Hungary adjust its cost-effectiveness threshold based on health gains?
- › How does Hungary’s current threshold compare to other European countries?
- › How can cost-effectiveness thresholds reflect a country’s economic performance?
- › Should different thresholds be used for rare diseases?
- › How can HTA decisions better reflect societal value for money in healthcare?
References & sources
Similar by meaning
- Irish Cost-Effectiveness Threshold (45,000/20,000 EUR per QALY)
- Hungarian Methodological Guidelines for Economic Evaluation of Healthcare Interventions
- Swedish severity-based cost-effectiveness threshold framework
- Cost-Effective but Unaffordable Paradox / Nonmarginal Health Opportunity Cost Method
- Methods for the Estimation of the NICE Cost-Effectiveness Threshold (Claxton supply-side threshold)
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