BACKGROUND: Health-state preferences can be combined with willingness-to-pay (WTP) data to calculate WTP per quality-adjusted life year (QALY). The WTP/QALY ratios provide insight into societal valuations of expenditures for medical interventions. METHODS: The authors measured preferences for current health in 3 patient populations (N = 391) using standard gamble, time trade-off, visual analog scale, and WTP, then they calculated WTP/QALY ratios. The ratios were compared with several proposed cost/QALY cost-effectiveness ratio thresholds, the value-of-life literature, and with WTP/QALY ratios derived from published preference research. RESULTS: Mean WTP/QALY ratios ranged from 12,500 to 32,200 US dollars (2003 US dollars). All values were below most published cost-effectiveness ratio thresholds, below the ratio from a prototypic medical treatment covered by Medicare (i.e., renal dialysis), and below ratios from the value-of-life literature. The WTP/QALY ratios were similar to those calculated from published preference data for patients with symptomatic meno-pause, dentofacial deformities, asthma, or dermatologic disorders. CONCLUSIONS: WTP/QALY ratios calculated using preference data collected from diverse populations are lower than most proposed thresholds for determining what is "cost-effective." Current proposed cost-effectiveness ratio thresholds may overestimate the willingness of society to pay for medical interventions.
BACKGROUND: Health-state preferences can be combined with willingness-to-pay (WTP) data to calculate WTP per quality-adjusted life year (QALY). The WTP/QALY ratios provide insight into societal valuations of expenditures for medical interventions. METHODS: The authors measured preferences for current health in 3 patient populations (N = 391) using standard gamble, time trade-off, visual analog scale, and WTP, then they calculated WTP/QALY ratios. The ratios were compared with several proposed cost/QALY cost-effectiveness ratio thresholds, the value-of-life literature, and with WTP/QALY ratios derived from published preference research. RESULTS: Mean WTP/QALY ratios ranged from 12,500 to 32,200 US dollars (2003 US dollars). All values were below most published cost-effectiveness ratio thresholds, below the ratio from a prototypic medical treatment covered by Medicare (i.e., renal dialysis), and below ratios from the value-of-life literature. The WTP/QALY ratios were similar to those calculated from published preference data for patients with symptomatic meno-pause, dentofacial deformities, asthma, or dermatologic disorders. CONCLUSIONS: WTP/QALY ratios calculated using preference data collected from diverse populations are lower than most proposed thresholds for determining what is "cost-effective." Current proposed cost-effectiveness ratio thresholds may overestimate the willingness of society to pay for medical interventions.
Authors: Pari V Pandharipande; Debra A Gervais; Rebecca I Hartman; Mukesh G Harisinghani; Adam S Feldman; Peter R Mueller; G Scott Gazelle Journal: Radiology Date: 2010-09 Impact factor: 11.105
Authors: Tracy A Lieu; G Thomas Ray; Ismael R Ortega-Sanchez; Ken Kleinman; Donna Rusinak; Lisa A Prosser Journal: Pharmacoeconomics Date: 2009 Impact factor: 4.981
Authors: Pamela P Pei; Milton C Weinstein; X Cynthia Li; Michael D Hughes; A David Paltiel; Taige Hou; Robert A Parker; Melanie R Gaynes; Paul E Sax; Kenneth A Freedberg; Bruce R Schackman; Rochelle P Walensky Journal: HIV Clin Trials Date: 2015-12-11