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Health Economics — CEA, QALY/DALY, Budget Impact, & Causal Inference

WHO-CHOICE CEA Threshold

Classify intervention cost-effectiveness using GDP per capita thresholds.

The marginal cost of health produced elsewhere in the system (Woods et al. 2016). When supplied, this drives the headline verdict; otherwise only the legacy GDP heuristic is shown.

Prefill from reference range for Kazakhstan: $2,200 – $6,000/DALY

Illustrative estimate from the opportunity-cost literature (Woods et al. 2016; Ochalek et al. 2018), NOT an official WHO threshold. Replace with a citable, country-specific value before publication or policy use.

No opportunity-cost threshold supplied

Enter a health-system opportunity-cost threshold above for the recommended verdict. Only the legacy GDP-multiple heuristic (below) is shown, which WHO and Bertram et al. (2016) have disavowed for decision-making.

Legacy heuristic (discouraged by WHO/Bertram 2016 — shown for reference)

Highly cost-effective

ICER: $5,000/DALY

$01x GDP ($11,477)3x GDP ($34,431)> 3x
ICER

GDP/capita

$11,477

ICER

$5,000

Ratio

0.44x GDP

Recommendations

No opportunity-cost threshold supplied

Caution

Enter a health-system opportunity-cost threshold (marginal cost per DALY/QALY) for the recommended verdict. Without it, only the legacy GDP-multiple heuristic is shown, which WHO and Bertram et al. (2016) have disavowed for decision-making.

ICER $5,000/DALY <= 1x GDP ($11,477)

Info

Highly cost-effective by WHO-CHOICE criteria. There is strong economic justification for adoption.

Important caveat

Info

WHO-CHOICE GDP thresholds are a simplified heuristic. More nuanced approaches such as opportunity cost and budget impact analysis are recommended for policy decisions.