Willingness to Pay for Health-Related Quality of Life Gains in Relation to Disease Severity and the Age of Patients
Objectives: Decision-making frameworks that draw on economic evaluations increasingly use equity weights to facilitate a
more equitable and fair allocation of healthcare resources. These weights can be attached to health gains or reflected in the
monetary threshold against which the incremental cost-effectiveness ratios of (new) health technologies are evaluated.
Currently applied weights are based on different definitions of disease severity and do not account for age-related
preferences in society. However, age has been shown to be an important equity-relevant characteristic. This study
examines the willingness to pay (WTP) for health-related quality of life (QOL) gains in relation to the disease severity and
age of patients, and the outcome of the disease.
Methods: We obtained WTP estimates by applying contingent-valuation tasks in a representative sample of the public in The Netherlands (n = 2023). We applied random-effects generalized least squares regression models to estimate the effect of patients’ disease severity and age, size of QOL gains, disease outcome (full recovery/death 1 year after falling ill), and respondent characteristics on the WTP.
Results: Respondents’WTP was higher for more severely ill and younger patients and for larger-sized QOL gains, but lower for patients who died. However, the relations were nonlinear and context dependent. Respondents with a lower age, who were male, had a higher household income, and a higher QOL stated a higher WTP for QOL gains.
Conclusions: Our results suggest that—if the aim is to align resource-allocation decisions in healthcare with societal preferences—currently applied equity weights do not suffice.
|age, end of life, health-related quality of life, severity of illness, willingness to pay|
|Value in Health|
|Organisation||Erasmus School of Health Policy & Management (ESHPM)|
Reckers-Droog, V.T, van Exel, N.J.A, & Brouwer, W.B.F. (2021). Willingness to Pay for Health-Related Quality of Life Gains in Relation to Disease Severity and the Age of Patients. Value in Health. doi:10.1016/j.jval.2021.01.012