Page 77 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders

4 The marginal benefits of healthcare spending in the Netherlands
Estimating cost-effectiveness thresholds using a translog production function
Stadhouders, N., Koolman , X., Van Dijk, C., Jeurissen, P., Adang, E. Submitted
New technologies may displace existing, higher-value care under a fixed budget. Countries aim to curtail adoption of low-value technologies, for example by installing cost effectiveness thresholds. Our objective is to estimate the opportunity cost of hospital care to identify a threshold value for the Netherlands. To this aim, we combine claims data, mortality data and quality of life questionnaires from 2012 to 2014 for 11,000 patient groups to obtain QALY outcomes and spending. Using a fixed effects translog model, we estimate that a 1% increase in hospital spending on average increases QALY outcomes by 0.2%. This implies a threshold of €73,600 per QALY, with 95% confidence intervals ranging from €53,000 to €94,000 per QALY. The results stipulate that new technologies with ICERs exceeding the Dutch upper reference value of €80.000 may indeed displace more valuable care.
Abstract
This research was supported by a grant from the National Health Care Institute (Zorginstituut Nederland). Preliminary results were presented at the 2016 EUHEA PhD student supervisor conference in Barcelona and at the 2017 iHEA conference in Boston. The authors are grateful for the contribution of the following persons: Joost Enzing, Peter Makai, Bert van Nistelrooij, James Lomas, Karl Claxton, Mark Sculpher and colleagues of the Centre of Health Economics, Laura Vallejo-Torres, Rogier Donders, Cihan Özdemir and Thom Dee.
Acknowledgements
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