Strategies for avoiding neglect of opportunity costs by decision-makers

Cost-effectiveness thresholds represent decision-makers’ maximum monetary valuation of a unit of outcome (typically a quality-adjusted life-year; QALY) in the context of decisions regarding the public funding of health technologies. If a technology is expected to generate additional QALYs at an incremental cost lower than the threshold, the technology is deemed to be cost effective. In this issue of Applied Health Economics and Health Policy, Lomas and colleagues note that the (policy) threshold used by the National Institute of Health and Care Excellence (NICE) is discrepant from the empirically estimated opportunity costs of the decisions made by NICE [1]. Here, we first confirm the relevance of empirical estimates of opportunity costs to informing the value of cost-effectiveness thresholds in different settings, and then build on Lomas et al.’s suggested strategy to avoid the neglect of empirical estimates of opportunity costs by decision-makers.