The ICER may be stated as (C1 – C0)/(E1 – E0) in a simple example where C0 and E0 represent the cost and gain, respectively, from taking no health intervention action.
It is important to note that CUA measures relative patient or general population utility of a treatment or pharmacoeconomic intervention.
According to a recent study "cost effectiveness often does not appear to be the dominant consideration in decisions about resource allocation made elsewhere in the NHS".
In the United Kingdom, in January 2005, the NICE is believed to have a threshold of about £30,000 per QALY – roughly twice the mean income after tax – although a formal figure has never been made public.
[citation needed] In North America, a similar figure of US$50000 per QALY is often suggested as a threshold ICER for a cost-effective intervention.
A complete compilation of cost–utility analyses in the peer reviewed medical literature is available at the CEA Registry Website On the plus side, CUA allows comparison across different health programs and policies by using a common unit of measure (money/QALYs gained).
This is because in CUA you need to measure the health improvement effects for every remaining year of life after the program is initiated.
Also, the weighting of QALYs through time-trade-off, standard gamble, or visual analogue scale is highly subjective.
Also, "The Secretary shall not utilize such an adjusted life year (or such a similar measure) as a threshold to determine coverage, reimbursement, or incentive programs under title XVIII".