Willingness to pay for one quality-adjusted life year in Iran
Abstract Background Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study expl...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | Cost Effectiveness and Resource Allocation |
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| Online Access: | http://link.springer.com/article/10.1186/s12962-019-0172-9 |
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| author | Najmeh Moradi Arash Rashidian Shirin Nosratnejad Alireza Olyaeemanesh Marzieh Zanganeh Leila Zarei |
| author_facet | Najmeh Moradi Arash Rashidian Shirin Nosratnejad Alireza Olyaeemanesh Marzieh Zanganeh Leila Zarei |
| author_sort | Najmeh Moradi |
| collection | DOAJ |
| description | Abstract Background Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study explored the threshold for use in the health system of Iran by determining society’s preferences. Methods A cross-sectional household survey based on the contingent valuation method was administered to a representative general population of 1002 in Tehran, Iran from April to June 2015. The survey was intended to estimate the respondents’ willingness-to-pay (WTP) preferences for one quality-adjusted life year (QALY) gained. The valuation scenarios featured 12 vignettes on mild to severe diseases that can change people’s quality of life. The mean of WTP for QALY was estimated using different health instruments, and the determinants of such willingness were analyzed using the Heckman selection model. Results WTP for QALY varied depending on the severity of a disease and the instrument used to determine health preferences. Mean low health state value were associated with high valuation. The best estimated WTP values ranged from US$1032 to US$2666 and 0.22–0.56 of Iran’s local gross domestic product (GDP) per capita in 2014. Except for educational level, significant variables differed across different disease scenarios. Generally, a high health state valuation for target diseases, high income, high educational level, and being married were associated with high WTP for QALY. Conclusion From the general public’s perspective, the monetary value of QALY for mild to severe diseases with no risk of death was less than one GDP per capita. Therefore, the obtained valuation range is recommended as reference only for the adoption of interventions designed to improve quality of life. Future studies should estimate the threshold of interventions for life-threatening diseases or formulate transparent policies in such contexts. |
| first_indexed | 2024-12-11T07:02:24Z |
| format | Article |
| id | doaj.art-1f4891518d4f4cb9b22dc44ac1e77267 |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-12-11T07:02:24Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-1f4891518d4f4cb9b22dc44ac1e772672022-12-22T01:16:36ZengBMCCost Effectiveness and Resource Allocation1478-75472019-02-0117111010.1186/s12962-019-0172-9Willingness to pay for one quality-adjusted life year in IranNajmeh Moradi0Arash Rashidian1Shirin Nosratnejad2Alireza Olyaeemanesh3Marzieh Zanganeh4Leila Zarei5Health Management and Economics Research Center, Iran University of Medical SciencesSchool of Public Health, Tehran University of Medical SciencesIranian Center of Excellence in Health Service Management, Tabriz University of Medical SciencesHealth Economics Department, National Institute for Health Research, Tehran University of Medical SciencesHealth Insurance Office, Ministry of Health and Medical EducationHealth Policy Research Center, Institute of Health, Shiraz University of Medical SciencesAbstract Background Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study explored the threshold for use in the health system of Iran by determining society’s preferences. Methods A cross-sectional household survey based on the contingent valuation method was administered to a representative general population of 1002 in Tehran, Iran from April to June 2015. The survey was intended to estimate the respondents’ willingness-to-pay (WTP) preferences for one quality-adjusted life year (QALY) gained. The valuation scenarios featured 12 vignettes on mild to severe diseases that can change people’s quality of life. The mean of WTP for QALY was estimated using different health instruments, and the determinants of such willingness were analyzed using the Heckman selection model. Results WTP for QALY varied depending on the severity of a disease and the instrument used to determine health preferences. Mean low health state value were associated with high valuation. The best estimated WTP values ranged from US$1032 to US$2666 and 0.22–0.56 of Iran’s local gross domestic product (GDP) per capita in 2014. Except for educational level, significant variables differed across different disease scenarios. Generally, a high health state valuation for target diseases, high income, high educational level, and being married were associated with high WTP for QALY. Conclusion From the general public’s perspective, the monetary value of QALY for mild to severe diseases with no risk of death was less than one GDP per capita. Therefore, the obtained valuation range is recommended as reference only for the adoption of interventions designed to improve quality of life. Future studies should estimate the threshold of interventions for life-threatening diseases or formulate transparent policies in such contexts.http://link.springer.com/article/10.1186/s12962-019-0172-9Willingness to payQuality-adjusted life yearCost-effectiveness threshold valueWHO threshold value |
| spellingShingle | Najmeh Moradi Arash Rashidian Shirin Nosratnejad Alireza Olyaeemanesh Marzieh Zanganeh Leila Zarei Willingness to pay for one quality-adjusted life year in Iran Cost Effectiveness and Resource Allocation Willingness to pay Quality-adjusted life year Cost-effectiveness threshold value WHO threshold value |
| title | Willingness to pay for one quality-adjusted life year in Iran |
| title_full | Willingness to pay for one quality-adjusted life year in Iran |
| title_fullStr | Willingness to pay for one quality-adjusted life year in Iran |
| title_full_unstemmed | Willingness to pay for one quality-adjusted life year in Iran |
| title_short | Willingness to pay for one quality-adjusted life year in Iran |
| title_sort | willingness to pay for one quality adjusted life year in iran |
| topic | Willingness to pay Quality-adjusted life year Cost-effectiveness threshold value WHO threshold value |
| url | http://link.springer.com/article/10.1186/s12962-019-0172-9 |
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