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

Medicine (Baltimore). 2018 Sep;97(38):e12453. doi: 10.1097/MD.0000000000012453.

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Attitude to Health
  • Choice Behavior / physiology*
  • Cost-Benefit Analysis / economics*
  • Decision Making / ethics
  • Female
  • Financing, Personal / statistics & numerical data
  • Health Status
  • Humans
  • Insurance, Health / economics
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Models, Economic
  • Quality-Adjusted Life Years*
  • Republic of Korea / epidemiology
  • Surveys and Questionnaires / statistics & numerical data