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Willingness to Pay per Quality-Adjusted Life Year in a Study of Knee Osteoarthritis

Author

Listed:
  • Margaret M. Byrne

    (Department of Epidemiology and Public Health, University of Miami, Florida, mbyrne2@med.miami.edu)

  • Kimberly O’Malley

    (Pearson Educational Measurement)

  • Maria E. Suarez-Almazor

    (Houston Center for Quality of Care and Utilization Studies, Veterans Health Affairs, Houston, Texas, Department of Medicine, Baylor College of Medicine, Houston, Texas)

Abstract

Background. Determining whether a particular medical intervention is cost-effective requires that a threshold of cost per benefit gained be established. As debate continues over the appropriate threshold, we present measures of willingness to pay (WTP) per quality-adjusted life year (QALY) for own health and 2 hypothetical osteoarthritis scenarios. Methods. One hundred ninety-three persons, located through random digit dialing in Harris County, Texas, completed face-to-face interviews collecting demographic information and health preferences using visual analog scale, time tradeoff, standard gamble, and WTP methodologies. Results. The mean WTP/QALY for all methods was lower (range, $1221-$5690/QALY) than many estimates from revealed preference studies and lower than the oft-cited arbitrary cutoff of $50 000. WTP/QALY was highest when participants were judging their personal health improvements as opposed to hypothetical scenarios. There were some significant differences in WTP/QALY across elicitation methodologies for the same scenario. Demographic characteristics were not associated with WTP/QALY measures. Conclusions. The health states and improvements in health evaluated here do not contain a risk of mortality, unlike many situations in which WTP/QALY has been previously evaluated. The lower WTP/QALY values found here may indicate that the presence of a mortality risk reduction substantially increases stated WTP/QALY. Appropriate thresholds for cost-effectiveness may be dependent on the context of a situation, including risk of mortality.

Suggested Citation

  • Margaret M. Byrne & Kimberly O’Malley & Maria E. Suarez-Almazor, 2005. "Willingness to Pay per Quality-Adjusted Life Year in a Study of Knee Osteoarthritis," Medical Decision Making, , vol. 25(6), pages 655-666, November.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:6:p:655-666
    DOI: 10.1177/0272989X05282638
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    References listed on IDEAS

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    1. Sloan, Frank A. & Kip Viscusi, W. & Chesson, Harrell W. & Conover, Christopher J. & Whetten-Goldstein, Kathryn, 1998. "Alternative approaches to valuing intangible health losses: the evidence for multiple sclerosis1," Journal of Health Economics, Elsevier, vol. 17(4), pages 475-497, August.
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    1. Odejar, Maria & Baker, Rachel & Ryan, Mandy & Donalson, Cam & Bateman, Ian J. & Jones-Lee, M & Lancsar, Emily & Mason, Helen & Pinto Paredes, JL & Robinson, A & Shackley, P & Smith, R & Sugdem, R & Wi, 2010. "Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project," MPRA Paper 108869, University Library of Munich, Germany.
    2. Afentoula G. Mavrodi & Vassilis H. Aletras, 2019. "Preliminary Results of a Healthcare Contingent Valuation Study in Greece," International Journal of Finance, Insurance and Risk Management, International Journal of Finance, Insurance and Risk Management, vol. 9(3-4), pages 3-16.
    3. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.

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