How much is a payer willing to pay for a QALY gain?

What a QALY is worth to a payer

Some payers weigh the cost per QALY gained against a threshold: the amount the health system is prepared to pay for one QALY. A treatment that comes in below that figure is considered value for money.
 

A worked example

A new treatment costs £60,000 and delivers three QALYs. That works out at £20,000 for each QALY gained. Imagine a country has set its threshold at £30,000 per QALY: at £20,000 the treatment stays below it, and on that basis deserves to be adopted.
 

Why the answer differs by country

Few countries state a threshold openly. Many apply one but avoid publishing it, because they are reluctant to communicate a figure too explicitly.

• The UK is an exception, with an explicit threshold of £30,000 per QALY.
• The Netherlands has published three, by disease severity: €20,000 per QALY for less severe conditions, €50,000 for moderate ones, and up to €80,000 for severe ones.
• In many other countries the decision is made dossier by dossier, with unofficial figures circulating but nothing set out in an official document.