Signature
EJP_L = (lambda_L * Delta_E - Delta_C_other) / U; EJP_U = (lambda_U * Delta_E - Delta_C_other) / U
| Inputs | Definition | Unit |
|---|---|---|
lambda_L | Lower threshold, for example GBP 25,000 per QALY | money per QALY |
Delta_E | Expected discounted QALYs per patient with the medicine minus those with the comparator, above zero | QALYs per patient |
Delta_C_other | Expected discounted incremental cost per patient excluding the medicine's acquisition cost, net of savings | money per patient |
U | Discounted number of units of the medicine per patient, above zero | units per patient |
lambda_U | Upper threshold, at or above lambda_L, for example GBP 35,000 per QALY | money per QALY |
EJP_L | Economically justifiable price per unit at the lower threshold lambda_L | money per unit |
|---|---|---|
EJP_U | Economically justifiable price per unit at the upper threshold lambda_U | money per unit |
Function
Economically justifiable price function solving the ICER for the unit price
Maps a cost-effectiveness threshold, the incremental QALYs per patient, the incremental cost per patient other than the new medicine's acquisition cost and the discounted number of units per patient to the highest price per unit at which the incremental cost-effectiveness ratio equals the threshold. It solves the two-option ICER of HE-FM-ICER-001 with the medicine's price as the unknown, and the same price sets the incremental net monetary benefit of HE-FM-NMB-002 to zero. The algebra matches the break-even price HE-FM-BEA-001 and, per patient, the payer's maximum price HE-FM-BARG-002; this package adds the threshold range, the NICE severity weight and the probabilistic forms used in an EJP analysis. Notation follows the Economically Justifiable Price article.
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Implementations
Excel
EJP at the lower and upper thresholds in two cells
With named cells ThresholdLow, ThresholdHigh, DeltaE, DeltaCOther and Units, the two formulas return the EJP per unit at each end of the range.
=(ThresholdLow*DeltaE-DeltaCOther)/Units; =(ThresholdHigh*DeltaE-DeltaCOther)/Units
Assumptions
Same model results at both ends of the EJP range
Only the threshold differs between the two prices; Delta_E, Delta_C_other and U are the same model results. Lower and higher QALY gain scenarios are produced by repeating the calculation with each scenario's inputs.
Thresholds for the EJP range checked at source
The thresholds are those the payer applies at the time of the analysis. NICE's manual, updated in March 2026, uses GBP 25,000 and GBP 35,000 per QALY, and GBP 100,000 per QALY for highly specialised technologies (PMG36 sections 6.3.4 and 6.3.8).
Worked examples
Drug X EJP range in the base case
With the article's base-case inputs Drug X has an EJP of GBP 740 per pack at GBP 25,000 per QALY and GBP 1,060 at GBP 35,000.
lambda_L = 25000; lambda_U = 35000; Delta_E = 0.80; Delta_C_other = 1500; U = 25; EJP_L = 740; EJP_U = 1060
Drug X EJP range in the lower QALY gain scenario
In the article's lower QALY gain scenario the QALY gain is 0.60, and the EJP falls to GBP 540 and GBP 780 per pack.
lambda_L = 25000; lambda_U = 35000; Delta_E = 0.60; Delta_C_other = 1500; U = 25; EJP_L = 540; EJP_U = 780
Drug X EJP range in the higher QALY gain scenario
In the article's higher QALY gain scenario the QALY gain is 1.00, and the EJP rises to GBP 940 and GBP 1,340 per pack.
lambda_L = 25000; lambda_U = 35000; Delta_E = 1.00; Delta_C_other = 1500; U = 25; EJP_L = 940; EJP_U = 1340
Common errors
Reporting one EJP as the justifiable price
A single figure hides the spread: across the two thresholds and three scenarios in the article, Drug X's EJP runs from GBP 540 to GBP 1,340 per pack. Reporting only GBP 740 or only GBP 1,060 overstates how precisely the evidence fixes the price.
Taking the EJP range from thresholds of an earlier analysis
Zeevat and colleagues used GBP 20,000 and GBP 30,000 per QALY for the United Kingdom in 2022. Those figures would give Drug X GBP 580 and GBP 900 per pack (computed here for illustration) instead of GBP 740 and GBP 1,060 at the thresholds in NICE's manual as updated in March 2026.
Sources
NICE thresholds for an EJP range
National Institute for Health and Care Excellence. NICE technology appraisal and highly specialised technologies guidance: the manual (PMG36). London: NICE; published 31 January 2022, last updated 31 March 2026. Sections 6.3.4 to 6.3.8: below a most plausible ICER of GBP 25,000 per QALY gained (GBP 100,000 for highly specialised technologies) the decision is normally based on the cost-effectiveness estimate; across GBP 25,000 to GBP 35,000 the committee refers explicitly to uncertainty, uncaptured benefits and health inequalities; above GBP 35,000 it needs an increasingly stronger case.
Zeevat on EJPs at two thresholds in two countries
Zeevat F, Luttjeboer J, Paulissen JHJ, van der Schans J, Beutels P, Boersma C, Postma MJ. Exploratory analysis of the economically justifiable price of a hypothetical RSV vaccine for older adults in the Netherlands and the United Kingdom. Journal of Infectious Diseases. 2022;226(Suppl 1):S102-S109. Methods (threshold analysis to calculate the EJP at each willingness-to-pay threshold) and results (EJPs at EUR 20,000 and EUR 50,000 per QALY in the Netherlands and GBP 20,000 and GBP 30,000 per QALY in the United Kingdom).
Canonical Identity
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