Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis

Margaret M Byrne, Kimberly O'Malley, Maria E. Suarez-Almazor

Research output: Contribution to journalArticle

46 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)655-666
Number of pages12
JournalMedical Decision Making
Volume25
Issue number6
DOIs
StatePublished - Nov 1 2005

Fingerprint

Quality-Adjusted Life Years
Knee Osteoarthritis
Health
Cost-Benefit Analysis
Mortality
Demography
Risk Reduction Behavior
Visual Analog Scale
Osteoarthritis
Interviews
Costs and Cost Analysis

Keywords

  • Cost-effectiveness
  • Quality-adjusted life year
  • Willingness-to-pay

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Informatics
  • Health Information Management
  • Nursing(all)

Cite this

Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis. / Byrne, Margaret M; O'Malley, Kimberly; Suarez-Almazor, Maria E.

In: Medical Decision Making, Vol. 25, No. 6, 01.11.2005, p. 655-666.

Research output: Contribution to journalArticle

Byrne, Margaret M ; O'Malley, Kimberly ; Suarez-Almazor, Maria E. / Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis. In: Medical Decision Making. 2005 ; Vol. 25, No. 6. pp. 655-666.
@article{f3f13f268f274c3482fe39c2a434b7df,
title = "Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis",
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 = "Cost-effectiveness, Quality-adjusted life year, Willingness-to-pay",
author = "Byrne, {Margaret M} and Kimberly O'Malley and Suarez-Almazor, {Maria E.}",
year = "2005",
month = "11",
day = "1",
doi = "10.1177/0272989X05282638",
language = "English",
volume = "25",
pages = "655--666",
journal = "Medical Decision Making",
issn = "0272-989X",
publisher = "SAGE Publications Inc.",
number = "6",

}

TY - JOUR

T1 - Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis

AU - Byrne, Margaret M

AU - O'Malley, Kimberly

AU - Suarez-Almazor, Maria E.

PY - 2005/11/1

Y1 - 2005/11/1

N2 - 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.

AB - 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.

KW - Cost-effectiveness

KW - Quality-adjusted life year

KW - Willingness-to-pay

UR - http://www.scopus.com/inward/record.url?scp=27944447233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27944447233&partnerID=8YFLogxK

U2 - 10.1177/0272989X05282638

DO - 10.1177/0272989X05282638

M3 - Article

C2 - 16282216

AN - SCOPUS:27944447233

VL - 25

SP - 655

EP - 666

JO - Medical Decision Making

JF - Medical Decision Making

SN - 0272-989X

IS - 6

ER -