Estimating the monetary value of a Quality-Adjusted Life-Year in Quebec

Christian R. C. Kouakou, Jie He and Thomas G. Poder ()
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Christian R. C. Kouakou: University of Sherbrooke
Thomas G. Poder: Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l’Est de l’Île de Montréal

The European Journal of Health Economics, 2024, vol. 25, issue 5, No 5, 787-811

Abstract: Abstract Background The value of a Quality-Adjusted Life-Year (QALY) is of great importance for the healthcare system. It helps when it comes to defining a cost-effectiveness threshold for the evaluation of health technologies. No willingness-to-pay value for a QALY exists in the province of Quebec, Canada. Objectives In this paper, we empirically investigated the monetary value of a QALY for the population of Quebec. Methods Based on the Short-Form 6-Dimension version 2 (SF-6Dv2), we conducted an online survey with a representative adult sample living in Quebec. We used a time trade-off (TTO) combined with contingent valuation (CV), and a discrete choice experiment (DCE) to assess both the population’s willingness to pay (WTP) for one QALY and the marginal WTP for health attributes. A health utility algorithm using hybrid regression was developed to determine a preference-based value set for health states. Results Main analysis was conducted on 993 answers for the CV and 2143 answers for the DCE. The willingness-to-pay per QALY varied from CA$ 47,048.84 (CI: 21,554.38; 72,543.30) for CV to CA$ 73,936.87 (CI: 63,105.40; 84,768.35) for DCE. Among the 6 dimensions of the SF-6Dv2, marginal WTP varied from CA$ 4499.15 (CI: 2975.06; 6023.25) for more role accomplishment in daily activities to CA$ 15,867.12 (CI: 13,825.75; 17,908.49) for less pain. Robustness check with multiple alternative samples, as well as alternative health utility algorithms, showed that the results were robust and the DCE method provided 50% larger results than the CV method, although confidence intervals overlap. Conclusion This paper provides useful information for decision-makers on the monetary value of a QALY in Quebec.

Keywords: QALY; WTP; Time trade-off; Contingent valuation; Discrete choice experiment; SF-6Dv2; Québec; D61; D81; I18 (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1007/s10198-023-01625-3

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