International Typical Application Patterns for Cost-Effectiveness Thresholds in Healthcare Reimbursement Decision-Ma king and Its Implication for China
Peng Xiaochen
Yang Minghao
Wang Haiyin
Abstract：Objective:To provide references and implications for China's drug reimbursement decision-making by analyzing the setting and application of cost-effectiveness thresholds.Methods:A literature review method was employed to examine the establishment of cost-effectiveness thresholds and their application patterns in decision-making for health technology assessment and drug reimbursement management in representative countries,including the UK.,US.,Germany,and Japan.Results:Through analyzing the application of cost-effectiveness thresholds in different countries'decision-making mechanisms,significant discrepancies were identified in pharmacoeconomic practices,with no single"perfect"model or unified standard available for direct adoption.Conclusion:In 2025,China will launch its first commercial health insurance list for innovative drugs,primarily focusing on high-value innovative medicines that go beyond the scope of"basic coverage".However,since the funding for this list will come from commercial health insurance,the application of pharmacoeconomic evaluations and the setting of cost-effectiveness thresholds will need to be redefined in accordance with the shifting decision-making objectives.Therefore,China should continue to investigate the application patterns of cost-effectiveness threshold in decision-making that align with its health insurance system,thereby further enhancing the scientific rationality of medical and healthcare reimbursement decisions and improving the efficiency of healthcare resource allocation.
Keywords：reimbursement decision makingcost-effectiveness thresholdapplication patternimplementation
Publication Date：2026-02-05
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：7( 90-96 )