Estimating a WTP-based value of a QALY: The ‘chained’ approach

Robinson, Angela, Gyrd-Hansen, Dorte, Bacon, Philomena, Baker, Rachel, Pennington, Mark and Donaldson, Cam (2013) Estimating a WTP-based value of a QALY: The ‘chained’ approach. Social Science and Medicine, 92. pp. 92-104. ISSN 0277-9536

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A major issue in health economic evaluation is that of the value to place on a quality adjusted life year (QALY), commonly used as a measure of health care effectiveness across Europe. This critical policy issue is reflected in the growing interest across Europe in development of more sound methods to elicit such a value. EuroVaQ was a collaboration of researchers from 9 European countries, the main aim being to develop more robust methods to determine the monetary value of a QALY based on surveys of the general public. The 'chained' approach of deriving a societal willingness-to-pay (WTP) based monetary value of a QALY used the following basic procedure. First, utility values were elicited for health states using the standard gamble (SG) and time trade off (TTO) methods. Second, a monetary value to avoid some risk/duration of that health state was elicited and the implied WTP per QALY estimated. We developed within EuroVaQ an adaptation to the 'chained approach' that attempts to overcome problems documented previously (in particular the tendency to arrive at exceedingly high WTP per QALY values). The survey was administered via Internet panels in each participating country and almost 22,000 responses achieved. Estimates of the value of a QALY varied across question and were, if anything, on the low side with the (trimmed) 'all country' mean WTP per QALY ranging from $18,247 to $34,097. Untrimmed means were considerably higher and medians considerably lower in each case. We conclude that the adaptation to the chained approach described here is a potentially useful technique for estimating WTP per QALY. A number of methodological challenges do still exist, however, and there is scope for further refinement.

Item Type: Article
Uncontrolled Keywords: europe,willingness to pay (wtp),wtp per qaly,contingent valuation (cv),stated preference,health state utility assessment,chained approach,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Science > School of Environmental Sciences
UEA Research Groups: Faculty of Science > Research Centres > Centre for Social and Economic Research on the Global Environment (CSERGE)
Faculty of Science > Research Groups > Resources, Sustainability and Governance (former - to 2018)
Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Faculty of Social Sciences > Research Centres > Centre for Behavioural and Experimental Social Sciences
Depositing User: Pure Connector
Date Deposited: 25 Sep 2013 01:02
Last Modified: 08 Jul 2023 23:40
DOI: 10.1016/j.socscimed.2013.05.013

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