EconPapers    
Economics at your fingertips  
 

Pricing implications of non-marginal budgetary impacts in health technology assessment: a conceptual model

Daniel Howdon () and James Lomas
Additional contact information
James Lomas: Centre for Health Economics, University of York, York, UK.

No 148cherp, Working Papers from Centre for Health Economics, University of York

Abstract: This paper introduces a framework by which to conceptualise the decision-making process in health technology assessment when the quantity of health forgone by acceptance is high enough such that the use of a single threshold based on the marginal productivity of the health care system is inappropriate, and draws out the implications of this for pharmaceutical pricing. Under the condition of perfect divisibility, a large budgetary impact of a new treatment may imply that optimal implementation may be partial rather than full, even at a given incremental cost effectiveness ratio (ICER) that would nevertheless mean the decision to accept the treatment in full would not lead to a net reduction in health. In a one-shot price setting game, this seems to give rise to horizontal equity concerns which may be more apparent than real. When the assumption of fixity of the ICER (arising from the assumed exogeneity of the manufacturer’s price) is relaxed, it can be shown that the threat of partial implementation may be sufficient to give rise to an ICER at which cost the entire potential population is treated, maximising health at an increased level, and with no contravention of the horizontal equity principle.

Keywords: health technology assessment; economic evaluation; budgetary impact (search for similar items in EconPapers)
JEL-codes: I10 I11 J18 (search for similar items in EconPapers)
Pages: 17 pages
Date: 2017-11
New Economics Papers: this item is included in nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed

Downloads: (external link)
https://www.york.ac.uk/media/che/documents/papers/ ... udgetary_impacts.pdf First version, 2017 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:148cherp

Access Statistics for this paper

More papers in Working Papers from Centre for Health Economics, University of York Contact information at EDIRC.
Bibliographic data for series maintained by Gill Forder ().

 
Page updated 2020-04-05
Handle: RePEc:chy:respap:148cherp