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Sample restrictions and the elicitation of a constant willingness to pay per quality adjusted life year

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  • Jytte Seested Nielsen
  • Dorte Gyrd‐Hansen
  • Trine Kjær

Abstract

It is well established that the underlying theoretical assumptions needed to obtain a constant proportional trade‐off between a quality adjusted life year (QALY) and willingness to pay (WTP) are restrictive and often empirically violated. In this paper, we set out to investigate whether the proportionality conditions (in terms of scope insensitivity and severity independence) can be satisfied when data is restricted to include only respondents who pass certain consistency criteria. We hypothesize that the more we restrict the data, the better the compliance with the requirement of constant proportional trade‐off between WTP and QALY. We revisit the Danish data from the European Value of a QALY survey eliciting individual WTP for a QALY (WTP‐Q). Using a “chained approach” respondents were first asked to value a specified health state using the standard gamble (SG) or the time‐trade‐off (TTO) approach and subsequently asked their WTP for QALY gains of 0.05 and 0.1 (tailored according to the respondent's SG/TTO valuation). Analyzing the impact of the different exclusion criteria on the two proportionality conditions, we find strong evidence against a constant WTP‐Q. Restricting our data to include only respondents who pass the most stringent consistency criteria does not impact on the performance of the proportionality conditions for WTP‐Q.

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  • Jytte Seested Nielsen & Dorte Gyrd‐Hansen & Trine Kjær, 2021. "Sample restrictions and the elicitation of a constant willingness to pay per quality adjusted life year," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 923-931, May.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:5:p:923-931
    DOI: 10.1002/hec.4236
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    References listed on IDEAS

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    1. Pinto-Prades, Jose Luis & Loomes, Graham & Brey, Raul, 2009. "Trying to estimate a monetary value for the QALY," Journal of Health Economics, Elsevier, vol. 28(3), pages 553-562, May.
    2. James K. Hammitt & Fangli Geng & Xiaoqi Guo & Chris P. Nielsen, 2019. "Valuing mortality risk in China: Comparing stated-preference estimates from 2005 and 2016," Journal of Risk and Uncertainty, Springer, vol. 58(2), pages 167-186, June.
    3. Linda Ryen & Mikael Svensson, 2015. "The Willingness to Pay for a Quality Adjusted Life Year: A Review of the Empirical Literature," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1289-1301, October.
    4. Ana Bobinac & Job Exel & Frans Rutten & Werner Brouwer, 2014. "The Value of a QALY: Individual Willingness to Pay for Health Gains Under Risk," PharmacoEconomics, Springer, vol. 32(1), pages 75-86, January.
    5. Bobinac, Ana & van Exel, N. Job A. & Rutten, Frans F.H. & Brouwer, Werner B.F., 2012. "GET MORE, PAY MORE? An elaborate test of construct validity of willingness to pay per QALY estimates obtained through contingent valuation," Journal of Health Economics, Elsevier, vol. 31(1), pages 158-168.
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    Cited by:

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