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Estimating a constant WTP for a QALY-a mission impossible?

Björn Sund^1,2, Mikael Svensson³

¹Swedish Civil Contingencies Agency (MSB), 651 81, Karlstad, Sweden. bjorn.sund@msb.se.

The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care

|September 22, 2017

Summary

This study investigated willingness to pay for a quality-adjusted life year (QALY). Results indicate that the amount people are willing to pay for improved quality of life does not increase with larger health gains or higher probabilities of improvement.

Keywords:

Contingent valuation Quality-adjusted life year Scope sensitivity Willingness to pay

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Area of Science:

Health Economics
Decision Science
Public Health Policy

Background:

Economic evaluations are crucial for healthcare decision-making and resource allocation.
Measuring public preferences for health improvements, such as willingness to pay for a quality-adjusted life year (QALY), is vital for interpreting economic evaluations.
Understanding the factors influencing willingness to pay for health gains is essential for accurate health policy development.

Purpose of the Study:

To examine whether willingness to pay for a quality-adjusted life year (WTP-Q) is influenced by the magnitude of health differences.
To assess if the probability of achieving health improvements affects WTP-Q.
To compare WTP-Q findings with previous studies conducted in Sweden.

Main Methods:

A contingent valuation survey was employed to gather data from 1400 respondents.
The survey was conducted in the spring of 2014.
Statistical analysis was performed on the collected data to determine the relationship between WTP-Q and the size/probability of health improvements.

Main Results:

The study found no support for the hypothesis that willingness to pay for a QALY is sensitive to the size of the health difference (scope sensitivity).
Similarly, WTP-Q did not appear to be significantly influenced by the probability of improvement.
The estimated WTP-Q values were found to be consistent with those reported in prior Swedish studies.

Conclusions:

Willingness to pay for quality-adjusted life years is not significantly affected by the expected size or probability of health improvements.
The findings suggest a potential decoupling of WTP-Q from objective measures of health gain magnitude and likelihood.
The study reinforces the need for careful consideration of public preferences in health economic evaluations, while also highlighting potential limitations in how these preferences are expressed in contingent valuation surveys.