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Moradi N, Rashidian A, Nosratnejad S, et al. Willingness to pay for one quality-adjusted life year in Iran. Cost Eff Resour Alloc. 2019;17:4doi: 10.1186/s12962-019-0172-9.
Moradi, N., Rashidian, A., Nosratnejad, S., Olyaeemanesh, A., Zanganeh, M., & Zarei, L. (2019). Willingness to pay for one quality-adjusted life year in Iran. Cost effectiveness and resource allocation : C/E, 174. https://doi.org/10.1186/s12962-019-0172-9
Moradi, Najmeh, et al. "Willingness to pay for one quality-adjusted life year in Iran." Cost effectiveness and resource allocation : C/E vol. 17 (2019): 4. doi: https://doi.org/10.1186/s12962-019-0172-9
Moradi N, Rashidian A, Nosratnejad S, Olyaeemanesh A, Zanganeh M, Zarei L. Willingness to pay for one quality-adjusted life year in Iran. Cost Eff Resour Alloc. 2019 Feb 28;17:4. doi: 10.1186/s12962-019-0172-9. eCollection 2019. PMID: 30867654; PMCID: PMC6396529.
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Cost Eff Resour Alloc. 2019 Feb 28;17:4. doi: 10.1186/s12962-019-0172-9. eCollection 2019.

Willingness to pay for one quality-adjusted life year in Iran.

Cost effectiveness and resource allocation : C/E

Najmeh Moradi, Arash Rashidian, Shirin Nosratnejad, Alireza Olyaeemanesh, Marzieh Zanganeh, Leila Zarei

Affiliations

  1. 1Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  2. 2School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  3. 3Iranian Center of Excellence in Health Service Management, Tabriz University of Medical Sciences, Tabriz, Iran.
  4. 4Health Economics Department, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
  5. 5Health Insurance Office, Ministry of Health and Medical Education, Tehran, Iran.
  6. 6Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

PMID: 30867654 PMCID: PMC6396529 DOI: 10.1186/s12962-019-0172-9

Abstract

BACKGROUND: Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study explored the threshold for use in the health system of Iran by determining society's preferences.

METHODS: A cross-sectional household survey based on the contingent valuation method was administered to a representative general population of 1002 in Tehran, Iran from April to June 2015. The survey was intended to estimate the respondents' willingness-to-pay (WTP) preferences for one quality-adjusted life year (QALY) gained. The valuation scenarios featured 12 vignettes on mild to severe diseases that can change people's quality of life. The mean of WTP for QALY was estimated using different health instruments, and the determinants of such willingness were analyzed using the Heckman selection model.

RESULTS: WTP for QALY varied depending on the severity of a disease and the instrument used to determine health preferences. Mean low health state value were associated with high valuation. The best estimated WTP values ranged from US$1032 to US$2666 and 0.22-0.56 of Iran's local gross domestic product (GDP) per capita in 2014. Except for educational level, significant variables differed across different disease scenarios. Generally, a high health state valuation for target diseases, high income, high educational level, and being married were associated with high WTP for QALY.

CONCLUSION: From the general public's perspective, the monetary value of QALY for mild to severe diseases with no risk of death was less than one GDP per capita. Therefore, the obtained valuation range is recommended as reference only for the adoption of interventions designed to improve quality of life. Future studies should estimate the threshold of interventions for life-threatening diseases or formulate transparent policies in such contexts.

Keywords: Cost-effectiveness threshold value; Quality-adjusted life year; WHO threshold value; Willingness to pay

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