Get access

Comparing WTP Values of Different Types of QALY Gain Elicited from the General Public

Authors

  • Mark Pennington,

    Corresponding author
    1. London School of Hygiene & Tropical Medicine, London, UK
    Search for more papers by this author
  • Rachel Baker,

    1. Yunus Centre for Social Business & Health, Glasgow Caledonian University, Glasgow, UK
    Search for more papers by this author
  • Werner Brouwer,

    1. Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
    Search for more papers by this author
  • Helen Mason,

    1. Yunus Centre for Social Business & Health, Glasgow Caledonian University, Glasgow, UK
    Search for more papers by this author
  • Dorte Gyrd Hansen,

    1. Institute of Public Health - Health Economics Unit, University of Southern Denmark, Denmark
    2. Danish Institute for Health Services Research, Copenhagen, Denmark
    Search for more papers by this author
  • Angela Robinson,

    1. School of Medicine, Health Policy & Practice, University of East Anglia, Norwich, UK
    Search for more papers by this author
  • Cam Donaldson,

    1. Yunus Centre for Social Business & Health, Glasgow Caledonian University, Glasgow, UK
    Search for more papers by this author
  • the EuroVaQ Team

    1. London School of Hygiene & Tropical Medicine, London, UK
    2. Yunus Centre for Social Business & Health, Glasgow Caledonian University, Glasgow, UK
    3. Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
    4. Institute of Public Health - Health Economics Unit, University of Southern Denmark, Denmark
    5. Danish Institute for Health Services Research, Copenhagen, Denmark
    6. School of Medicine, Health Policy & Practice, University of East Anglia, Norwich, UK
    Search for more papers by this author
    • The EuroVaQ Team is composed of: Cam Donaldson, Rachel Baker, Helen Mason (Glasgow Caledonian University & Newcastle University); Mark Pennington (London School of Hygiene & Tropical Medicine and Newcastle University); Sue Bell, Michael Jones-Lee, John Wildman (Newcastle University); Emily Lancsar (Monash University, Melbourne); Angela Robinson, Philomena Bacon (University of East Anglia); Jan Abel Olsen (University of Tromso), Dorte Gyrd-Hansen, Trine Kjaer, Mickael Beck, Jytte Seested Nielsen (University of Southern Denmark); Ulf Persson, Annika Bergman (Swedish Institute of Health Economics, Lund); Christel Protière, Jean Paul Moatti (INSERM, U-912, Université Aix-Marseille); Stephane Luchini (GREQAM, Centre National de la Recherche Scientifique, Marseille); Jose Luis Pinto Prades (Glasgow Caledonian University & Pablo de Olavide University, Seville); Awad Mataria, Rana Khatib, Yara Jaralla (Birzeit University, OPT); Werner Brouwer, Job van Exel (Erasmus University, Rotterdam); Roman Topór-Madry, Adam Kozierkiewicz, Darek Poznanski, Ewa Kocot (Jagiellonian University Medical College, Krakow, Poland); László Gulácsi, Márta Péntek (Corvinus University Budapest); Samer Kharroubi, Andrea Manca (University of York); Phil Shackley (University of Sheffield)


Abstract

Background

The appropriate thresholds for decisions on the cost-effectiveness of medical interventions remain controversial, especially in ‘end-of-life’ situations. Evidence of the values placed on different types of health gain by the general public is limited.

Methods

Across nine European countries, 17 657 people were presented with different hypothetical health scenarios each involving a gain of one quality adjusted life year (QALY) and asked about their willingness to pay (WTP) for that gain. The questions included quality of life (QoL) enhancing and life extending health gains, and a scenario where respondents faced imminent, premature death.

Results

The mean WTP values for a one-QALY gain composed of QoL improvements were modest (PPP$11 000). When comparing QALY gains obtained in the near future, the valuation of life extension exceeded the valuation of QoL enhancing gains (mean WTP PPP$19 000 for a scenario in which a coma is avoided). The mean WTP values were higher still when respondents faced imminent, premature death (PPP$29 000).

Conclusions

Evidence from the largest survey on the value of health gains by the general public indicated a higher value for life extending gains compared with QoL enhancing gains. A further modest premium may be indicated for life extension when facing imminent, premature death. Copyright © 2013 John Wiley & Sons, Ltd.

Ancillary