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Observational Study
. 2018 Sep;97(38):e12453.
doi: 10.1097/MD.0000000000012453.

Evaluation of willingness to pay per quality-adjusted life year for a cure: A contingent valuation method using a scenario-based survey

Hyun Jin Song  1 , Eui-Kyung Lee
Affiliations
Observational Study

Evaluation of willingness to pay per quality-adjusted life year for a cure: A contingent valuation method using a scenario-based survey

Hyun Jin Song et al. Medicine (Baltimore). 2018 Sep.

Abstract

Cost-effectiveness is 1 of the most important factors in medicine reimbursement, and social willingness to pay (WTP) can provide evidence for the threshold of cost-effectiveness analysis. Recently, the concept of curative medicines has been introduced, so it is necessary to study their cost-effectiveness. This study aimed to estimate WTP per quality-adjusted life year (QALY) for a cure in the Korean general population.A total of 507 people from the general population, proportionally assigned by sex, age, and region, participated in face-to-face interviews. The contingent valuation survey was conducted with scenarios involving 4 EuroQol-5 dimensions (EQ-5D) with different health statuses. We assumed a treatment that moved the health status of each scenario to perfect health. WTP for 1 year of treatment was derived using a double-bounded format followed by open-ended answers. In the cure scenario, the post-treatment effect continued for a lifetime; in the non-cure scenario, the effect instantly stopped when treatment was terminated. Additionally, prolonged treatment effects lasting 5 and 10 years were added. To identify the factors influencing WTP, a multi-level analysis was performed.WTP per QALY for the non-cure scenario was KRW 15 million/QALY. For the cure scenario, WTP was 2.3 times higher (KRW 35 million/QALY) than in the non-cure scenario. The results for the prolonged treatment effect scenarios were KRW 22 million/QALY and KRW 27 million/QALY, which are 1.4 and 1.8 times higher than the non-cure scenario, respectively. In all scenarios, the statistically significant factors affecting WTP per QALY were higher education, higher household income, and healthcare provider.This study revealed that WTP for a cure treatment was higher than that for non-cure; this higher WTP should be considered in future decision-making regarding curative treatments.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Description of scenarios A. each scenario from 1 to 4 B. moving health status by treatment.
Figure 2
Figure 2
Open-ended answers for each scenario A. Willingness to pay (amount of response) B. Willingness to pay per quality-adjusted life year.
See this image and copyright information in PMC

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