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Background and Objective <p>Cost-effectiveness thresholds (CETs) are essential for health technology assessments and resource allocation in healthcare. However, empirical CET estimates alongside quality-adjusted life expectancy are absent for the Hong Kong Special Administrative Region of China (Hong Kong SAR), Taiwan Province of China (Taiwan Province), and Singapore. This study aims to estimate quality-adjusted life expectancy and derive CETs in these regions.</p> Methods <p>Quality-adjusted life expectancy was calculated by using the Sullivan method. The CET was estimated using the value of a statistical life-based method, adjusted for age-specific life expectancy and health utilities to derive value of a statistical quality-adjusted life-year. Population-weighted value of a statistical quality-adjusted life-year values yielded regional CETs. Final estimates were corrected for overestimation, and sensitivity analyses were conducted.</p> Results <p>Quality-adjusted life expectancy estimates at birth were 79.98, 76.73, and 79.48 quality-adjusted life-years for Hong Kong SAR, Taiwan Province, and Singapore, respectively. Base-case CETs, expressed as times of gross domestic product per capita, were 3.12 (95% confidence interval 2.38–3.88), 2.15 (95% confidence interval 0.85–3.37), and 3.30 (95% confidence interval 1.77–4.74) for the three regions, respectively. Sensitivity analyses showed CET ranges of 2.86–3.46 (Hong Kong SAR), 2.00–2.39 (Taiwan Province), and 3.07–3.66 (Singapore) times of gross domestic product per capita for utility variations, and 2.02–3.98 (Hong Kong SAR), 1.43–2.71 (Taiwan Province), and 2.11–4.23 (Singapore) times of gross domestic product per capita for discount rate changes.</p> Conclusions <p>This study provides the first value of a statistical life-based CET estimates integrated with quality-adjusted life expectancy for three high-income regions in Asia. Focusing on context-specific thresholds beyond the World Health Organization benchmarks, the current findings offer a scientific basis for health technology assessments and policy decisions.</p>

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Quality-Adjusted Life Expectancy and Cost-Effectiveness Thresholds in Three High-Income Regions in Asia

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Xinyu Zhao,
  • Yawen Jiang

摘要

Background and Objective

Cost-effectiveness thresholds (CETs) are essential for health technology assessments and resource allocation in healthcare. However, empirical CET estimates alongside quality-adjusted life expectancy are absent for the Hong Kong Special Administrative Region of China (Hong Kong SAR), Taiwan Province of China (Taiwan Province), and Singapore. This study aims to estimate quality-adjusted life expectancy and derive CETs in these regions.

Methods

Quality-adjusted life expectancy was calculated by using the Sullivan method. The CET was estimated using the value of a statistical life-based method, adjusted for age-specific life expectancy and health utilities to derive value of a statistical quality-adjusted life-year. Population-weighted value of a statistical quality-adjusted life-year values yielded regional CETs. Final estimates were corrected for overestimation, and sensitivity analyses were conducted.

Results

Quality-adjusted life expectancy estimates at birth were 79.98, 76.73, and 79.48 quality-adjusted life-years for Hong Kong SAR, Taiwan Province, and Singapore, respectively. Base-case CETs, expressed as times of gross domestic product per capita, were 3.12 (95% confidence interval 2.38–3.88), 2.15 (95% confidence interval 0.85–3.37), and 3.30 (95% confidence interval 1.77–4.74) for the three regions, respectively. Sensitivity analyses showed CET ranges of 2.86–3.46 (Hong Kong SAR), 2.00–2.39 (Taiwan Province), and 3.07–3.66 (Singapore) times of gross domestic product per capita for utility variations, and 2.02–3.98 (Hong Kong SAR), 1.43–2.71 (Taiwan Province), and 2.11–4.23 (Singapore) times of gross domestic product per capita for discount rate changes.

Conclusions

This study provides the first value of a statistical life-based CET estimates integrated with quality-adjusted life expectancy for three high-income regions in Asia. Focusing on context-specific thresholds beyond the World Health Organization benchmarks, the current findings offer a scientific basis for health technology assessments and policy decisions.