A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?

Nimdet, Khachapon, Chaiyakunapruk, Nathorn, Vichansavakul, Kittaya and Ngorsuraches, Surachat (2015) A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?. PLoS ONE, 10 4: 1-16. doi:10.1371/journal.pone.0122760


Author Nimdet, Khachapon
Chaiyakunapruk, Nathorn
Vichansavakul, Kittaya
Ngorsuraches, Surachat
Title A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2015-04-09
Year available 2015
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1371/journal.pone.0122760
Open Access Status DOI
Volume 10
Issue 4
Start page 1
End page 16
Total pages 16
Place of publication San Francisco, CA United States
Publisher Public Library of Science
Collection year 2016
Language eng
Formatted abstract
Background

A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation.

Objective

To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors.

Methods

We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors.

Results

Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06).

Conclusion

This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per capita depended on several factors may prompt discussions on the CE threshold policy. Our research work provides a foundation for defining future direction of decision criteria for an evidence-informed decision making system.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2016 Collection
School of Public Health Publications
 
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