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The Value of a QALY: Individual Willingness to Pay for Health Gains Under Risk

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Abstract

Background

There is an increased interest in the monetary value of a quality-adjusted life-year (QALY). Past studies commonly derived willingness to pay (WTP) for certain future QALY gains. However, obtaining valid WTP per QALY estimates proved to be difficult.

Objective

We conducted a contingent valuation study and estimated the individual WTP per QALY under risk. We demonstrate the impact of probability weighting on WTP per QALY estimates in the Netherlands.

Results

Our estimates of the value of a QALY are in the range of €80,000–110,000 when the weighting correction was applied, and €250,500 without correction. The validity of these estimates, applying probability weighting, appears to be good.

Conclusions

Given the reasonable support for their validity and practical meaningfulness, the estimates derived while correcting for probability weighting may provide valuable input for the debate on the consumption value of health. While decision makers should not apply these estimates without further consideration, since strictly individual valuations may not carry all relevant information and values for societal decision-making, the current estimates may provide a good and informed basis for further discussion and study of this important topic.

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Acknowledgments

This study is part of a larger project investigating the broader societal benefits of healthcare, which was financially supported by Astra-Zeneca, GlaxoSmithKline, Janssen-Cilag, Merck and Pfizer BV. The researchers were free in study design, data collection, analysis and interpretation, as well as writing and submitting the manuscript for publication. The views expressed in this paper are those of the authors.

Author’s contributions

Ana Bobinac: design of the study, data collection, analysis and interpretation of results, drafting of the article, final approval of the article, critical revision of the article for important intellectual content.

Job van Exel: design of the study, analysis and interpretation of results, critical revision of the article for important intellectual content.

Frans F.H. Rutten: critical revision of the article for important intellectual content.

Werner B.F. Brouwer: design of the study, interpretation of results, critical revision of the article for important intellectual content.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam (iBMG/iMTA), P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Ana Bobinac, Job van Exel, Frans F. H. Rutten & Werner B. F. Brouwer

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  1. Ana Bobinac
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  2. Job van Exel
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Correspondence to Ana Bobinac.

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Bobinac, A., van Exel, J., Rutten, F.F.H. et al. The Value of a QALY: Individual Willingness to Pay for Health Gains Under Risk. PharmacoEconomics 32, 75–86 (2014). https://doi.org/10.1007/s40273-013-0110-1

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