Willingness to Pay per Quality-Adjusted Life Year in a Study of Knee Osteoarthritis

Margaret M. Byrne, Kimberly O’Malley and Maria E. Suarez-Almazor
Additional contact information
Margaret M. Byrne: Department of Epidemiology and Public Health, University of Miami, Florida, mbyrne2@med.miami.edu
Kimberly O’Malley: Pearson Educational Measurement
Maria E. Suarez-Almazor: Houston Center for Quality of Care and Utilization Studies, Veterans Health Affairs, Houston, Texas, Department of Medicine, Baylor College of Medicine, Houston, Texas

Medical Decision Making, 2005, vol. 25, issue 6, 655-666

Abstract: Background. Determining whether a particular medical intervention is cost-effective requires that a threshold of cost per benefit gained be established. As debate continues over the appropriate threshold, we present measures of willingness to pay (WTP) per quality-adjusted life year (QALY) for own health and 2 hypothetical osteoarthritis scenarios. Methods. One hundred ninety-three persons, located through random digit dialing in Harris County, Texas, completed face-to-face interviews collecting demographic information and health preferences using visual analog scale, time tradeoff, standard gamble, and WTP methodologies. Results. The mean WTP/QALY for all methods was lower (range, $1221-$5690/QALY) than many estimates from revealed preference studies and lower than the oft-cited arbitrary cutoff of $50 000. WTP/QALY was highest when participants were judging their personal health improvements as opposed to hypothetical scenarios. There were some significant differences in WTP/QALY across elicitation methodologies for the same scenario. Demographic characteristics were not associated with WTP/QALY measures. Conclusions. The health states and improvements in health evaluated here do not contain a risk of mortality, unlike many situations in which WTP/QALY has been previously evaluated. The lower WTP/QALY values found here may indicate that the presence of a mortality risk reduction substantially increases stated WTP/QALY. Appropriate thresholds for cost-effectiveness may be dependent on the context of a situation, including risk of mortality.

Keywords: willingness-to-pay; quality-adjusted life year; cost-effectiveness (search for similar items in EconPapers)
Date: 2005
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:25:y:2005:i:6:p:655-666

DOI: 10.1177/0272989X05282638

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