International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?
Although the threshold of cost effectiveness of medical interventions is thought to be 20 000- 30 000 UK pounds in the UK, and $50 000-$100 000 in the US, it is well known that these values are unjustified, due to lack of explicit scientific evidence. We measured willingness-to-pay (WTP) for one additional quality-adjusted life-year gained to determine the threshold of the incremental cost-effectiveness ratio. Our study used the Internet to compare WTP for the additional year of survival in a perfect status of health in Japan, the Republic of Korea (ROK), Taiwan, Australia, the UK, and the US. The research utilized a double-bound dichotomous choice, and analysis by the nonparametric Turnbull method. WTP values were JPY 5 million (Japan), KWN 68 million (ROK), NT$ 2.1 million (Taiwan), 23 000 UK pounds (UK), AU$ 64 000 (Australia), and US$ 62 000 (US). The discount rates of outcome were estimated at 6.8% (Japan), 3.7% (ROK), 1.6% (Taiwan), 2.8% (UK), 1.9% (Australia), and 3.2% (US). Based on the current study, we suggest new classification of cost-effectiveness plane and methodology for decision making.
Shiroiwa
Takeru
T
Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan. t.shiroiwa@gmail.com
Sung
Yoon-Kyoung
YK
Fukuda
Takashi
T
Lang
Hui-Chu
HC
Bae
Sang-Cheol
SC
Tsutani
Kiichiro
K
D000328:Adult; D001294:Attitude to Health; D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D019049:Developed Countries; D005260:Female; D005382:Financing, Personal; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D055815:Young Adult