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International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?

  • Takeru Shiroiwa

    (Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan)

  • Yoon-Kyoung Sung

    (Department of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea)

  • Takashi Fukuda

    (Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan)

  • Hui-Chu Lang

    (Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan)

  • Sang-Cheol Bae

    (Department of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea)

  • Kiichiro Tsutani

    (Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan)

Registered author(s):

    Although the threshold of cost effectiveness of medical interventions is thought to be £20 000-£30 000 in the UK, and $50 000-$100 000 in the US, it is well known that these values are unjustified, due to lack of explicit scientific evidence. We measured willingness-to-pay (WTP) for one additional quality-adjusted life-year gained to determine the threshold of the incremental cost-effectiveness ratio. Our study used the Internet to compare WTP for the additional year of survival in a perfect status of health in Japan, the Republic of Korea (ROK), Taiwan, Australia, the UK, and the US. The research utilized a double-bound dichotomous choice, and analysis by the nonparametric Turnbull method. WTP values were JPY 5 million (Japan), KWN 68 million (ROK), NT$ 2.1 million (Taiwan), £23 000 (UK), AU$ 64 000 (Australia), and US$ 62 000 (US). The discount rates of outcome were estimated at 6.8% (Japan), 3.7% (ROK), 1.6% (Taiwan), 2.8% (UK), 1.9% (Australia), and 3.2% (US). Based on the current study, we suggest new classification of cost-effectiveness plane and methodology for decision making. Copyright © 2009 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1481
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    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 19 (2010)
    Issue (Month): 4 ()
    Pages: 422-437

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    Handle: RePEc:wly:hlthec:v:19:y:2010:i:4:p:422-437
    Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Nancy Devlin & David Parkin, 2004. "Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 437-452.
    2. Basu, Anirban & Meltzer, David, 2005. "Implications of spillover effects within the family for medical cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 24(4), pages 751-773, July.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453, March.
    4. Dorte Gyrd-Hansen, 2003. "Willingness to pay for a QALY," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1049-1060.
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