As people become wealthier, they generally spend more money on health. However, as countries become richer, do they spend more or less (relative to GDP per capita) on health care innovation?
A paper by Yu et al. (2026) look at trends in willingness to pay limits between the US and countries included in the most favored nation (MFN) basket. Cost-effectiveness analyzes and thresholds quoted by payers in different countries are examined. They found that MFN countries have set funding limits for health innovations less generously in recent decades than in previous decades (1979–2023):
Among MFN studies, the proportion citing the threshold at or below the 1× GDP per capita benchmark increased over time and recently became the majority in the post-2020 period. In contrast, US studies consistently cite a threshold above the 1× benchmark in all periods, citing a lower threshold that results in only a temporary increase in the stock. Results limited to pharmaceutical CEA are consistent with key findings
The authors also note that “cancer-related CEA and pharmaceutical intervention were more likely to cite higher thresholds in CEA.”
In short, non-US countries have been becoming stingier (relative to their economies) over the last ~45 years. You can read the full study here.
