Objective: The aim of this study was to elicit the individual willingness to pay (WTP) for a quality-adjusted life-year (QALY). Methods: In a Web-based questionnaire containing contingent valuation exercises, respondents valued health changes in five scenarios. In each scenario, the respondents first valued two health states on a visual analog scale (VAS) and expressed their WTP for avoiding a decline in health from the better health state to the worse, using a payment scale followed by a bounded open contingent valuation question. Analysis: WTP per QALY was calculated for QALY gains calculated using VAS valuations, as well as the Dutch EQ-5D tariffs, the two steps in the WTP estimations and each scenario. Heterogeneity in WTP per QALY ratios was examined from the perspective of: 1) household income; and 2) the level of certainty in WTP indicated by respondents. Theoretical validity was analyzed using clustered multivariate regressions. Results: A total of 1091 respondents, representative of the Dutch population, participated in the survey. Mean WTP per QALY was €12,900 based on VAS valuations, and €24,500 based on the Dutch EuroQoL tariffs. WTP per QALY was strongly associated with income, varying from €5000 in the lowest to €75,400 in the highest income group. Respondents indicating higher certainty exhibited marginally higher WTP. Regression analyses confirmed expected relations between WTP per QALY, income, and other personal characteristics. Conclusion: Individual WTP per QALY values elicited in this study are similar to those found in comparable studies. The use of individual valuations in social decision-making deserves attention, however.

Additional Metadata
Keywords cost-effectiveness, individual preferences, QALY, resource allocation, WTP
Persistent URL dx.doi.org/10.1111/j.1524-4733.2010.00781.x, hdl.handle.net/1765/62089
Journal Value in Health
Citation
Bobinac, A, van Exel, N.J.A, Rutten, F.F.H, & Brouwer, W.B.F. (2010). Willingness to pay for a quality-adjusted life-year: The individual perspective. Value in Health, 13(8), 1046–1055. doi:10.1111/j.1524-4733.2010.00781.x