Let’s get the threshold right and stop the killing

Speaker: Tony Culyer

Date: Friday, May 5th from 10 AM – 12 PM

Location: HS 100 (Health Sciences Building, 155 College Street, Toronto ON)


The idea of a critical cost-effectiveness ratio for selecting health care interventions for inclusion in a national health plan has proved controversial. It has a long history. There is also a long history of error – both in getting the idea of the willingness to pay threshold wrong and applying it to the detriment of population health. The problem is worst in low and middle income countries, with the World Health Organization (WHO) a main mischief maker. A majority (I suspect) of WHO public health specialists in global health aid and abet these issues. The first step to stopping the killing is to get our ideas straight.

Tony Colyer


Tony Culyer is emeritus professor of economics at York (England); Senior Fellow at the Institute of Health Policy, Management and Evaluation at the University of Toronto; Chair, NICE International Advisory Group, London, England; and Distinguished Visiting Scholar, University of the Witwatersrand, South Africa.

He was the founding Organiser of the UK Health Economists’ Study Group. For 33 years he was the founding co-editor, with Joe Newhouse, of Journal of Health Economics. He was founding Vice Chair of the National Institute for Health and Care Excellence (NICE). He is Editor-in-Chief of the on-line Encyclopaedia of Health Economics. He was responsible for the 1994 report that led to the redesign of the NHS’s R&D system. For many years he was chair of the Department of Economics & Related Studies at York and, for six of them, was also deputy vice-chancellor. In Ontario he helped to found the Citizens’ Council and the Occupational Cancer Research Centre. For several years he chaired the WSIB’s Research Advisory Council. He has been a member of the Ontario Health Quality Council Advisory Committee, Clinical Standards, Guidelines and Quality Committee of the Board of CCO, and a Director of CADTH. He has been a visiting professor at Queen’s, Trent and UofT.

He is the 2015 recipient of the Baxter Foundation’s William B. Graham Prize for Health Services Research, the 2015 Emmett Hall Laureate and Hall Lecturer and the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Avedis Donabedian Outcomes Research Lifetime Achievement Award.

He has published widely, mostly in health economics. The third edition of his The Dictionary of Health Economics (Edward Elgar) came out in 2014. A collection of his non-technical essays called The Humble Economist is available on-line free of charge.

Link to recording: