P042 – To CET or Not to CET: That is the Question

Organized Session 12

Date: Wednesday 8 May 2024
Time: 16:30 - 17:45 PM
Room: Thonburi
Speakers: Alec Morton, Yot Teerawattananon, Hwee Lin Wee, Zhao Lin, Justice Nonvignon, Gavin Surgey, Jeffrey Hoch, Wanrudee Isaranuwatchai

Details descriptions of the session:

This session aims to introduce the concept of cost-effectiveness threshold (CET), specifically on how it can be used to support decision-making process to improve the efficiency of a healthcare system.

Economic evidence (cost-effectiveness information) can be used to inform policy-making process in supporting the priority setting movement towards universal health coverage. Public healthcare payers around the world are progressively using economic evidence to inform decision-making (such as whether to include a medicine in healthcare benefit package).

Often, these decisions are based on an incremental cost-effectiveness ratio (ICER), which represents additional cost per an additional unit of health gain, frequently expressed as quality-adjusted life year (QALY) gained. ICER compares costs occurred and health benefits yielded from a new health intervention as compared to the standard care or next best alternative. The intervention is considered cost-effective (representing a good value-for-money), if the ICER is less than the maximum financial investment that a public payer will commit to generate a unit of health gain, which is known as a CET. When properly used, CET enhances health maximization, and ensures consistent decision making across different types of health interventions and disease areas. However, opponents of CETs have argued that they have negative consequences including driving out deliberation and encouraging manufacturers to “bid up” to the threshold.

Learning objectives:
  • To understand the what, why, and how CET can be used to support priority setting process (to improve the efficiency of our healthcare system)
  • To better understand the current debate on whether or not each country should have an explicit CET
  • To discuss other ongoing debates of CET (e.g. whether a higher CET is better than a lower one)
Target audience:
  • Policy-makers, researchers, anyone who would like to improve the efficiency of their healthcare system
Structure of presentation:

The presentation structure will take the form of an organized debate with the proposed schedule below. The pro (affirmative) team (N~3) will support “to have” an explicit CET, whereas the against (negative) team (N~3) will argue for “to not have” an explicit CET. The debate will be followed by an open Q&A with the audience. Additionally, there will be an interactive activity to engage with the stakeholders to vote for their preferred choice (to have or not to have an explicit CET) at the beginning of the session, and at the end before the session adjourns.

Proposed schedule (75 minutes):

  • Scene setting by the moderator (e.g. what is CET and how CET is used or not used)- Moderators (15 mins)
  • Participants to vote before the start of the debate (5 mins)
  • Pro team will deliver their points – Speaker Pro-1 (5 mins)
  • Against team will deliver their points – Speaker Against-1 (5 mins)
  • Rebuttal by the pro team – Speaker Pro-2 (5 mins)
  • Rebuttal by the against team – Speaker Against-2 (5 mins)
  • Final point by the pro team – Speaker Pro-3 (5 mins)
  • Final point by the against team- Speaker Against-3 (5 mins)
  • Conclusion by the moderator – Moderators (10 mins)
  • Open Q&A (10 mins)
  • Participants to vote again after the debate (5 mins)
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