An estimation of cost effectiveness threshold: monetary value of a QALY

Abstract

Abstract Introduction: Cost-effectiveness threshold represents the maximum monetary amount per health outcome that is used to adopt a new intervention or technology and is used as a simple decision tool to determine cost-effective interventions. Different jurisdictions apply this tool to maximize the monetary investment that is needed to give a patient more QALY. One way to derive this cost-effectiveness threshold is using the willingness to pay approach. The purpose of this study is to estimate the monetary value of a QALY using the willingness to pay technique. Method: For this purpose, a study in accordance with the socio-economic context of Iran, in the metropolis of Tabriz among 304 samples, using a contingent valuation method and the willingness to pay approach has been conducted. The data of this research gathered by the field observations of the researcher, conducting interviews and completing a questionnaire. Data analysis was performed using EXCEL and STATA 16 software and Weibull regression model. Results: The findings showed that the median willingness to pay of Tabriz citizens for a QALY is 715001033 Rials, which according to the instructions of the World Health Organization is 1.05 times the GDP per capita of Iran in 2017, that is lower than WHO’s recommended cost effectiveness threshold. Discussion and Conclusion: Income, level of education and number of children were significant variables of study. The effect of other variables such as education, gender, employment status, age and marriage status on the willingness to pay was not significant. The result of the present study criticizes the contractual threshold of the World Health Organization because the criteria of the World Health Organization as a proposed threshold for countries may lead to lack of investment in essential health sectors or overinvestment in unnecessary health care sectors and interventions. Key words: cost effectiveness threshold, willingness to pay, QALY, general population, contingent valuation