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Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression

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Abstract

The use of a threshold for cost-utility studies is of major importance to health authorities for making the best allocation decisions for limited resources. Regarding the increasing number of studies worldwide that seek to establish a value for a quality-adjusted life year (QALY), it is necessary to review these studies to provide a global insight into the literature. A systematic review on willingness to pay (WTP) studies focusing on QALY was conducted in eight databases up to June 26, 2020. From a total of 9991 entries, 39 studies were selected, and 511 observations were extracted for the meta-analysis using the ordinary least squares method. The results showed a predicted mean empirical value of $52,619.39 (95% CI 49,952.59; 55,286.19) per QALY in US dollars for 2018. A 1% increase in income led to an increase of 0.6% in the WTP value, while a 1-year increase in respondent age led to a decrease of 3.3% in the WTP value. Sex, education level and employment status had significant effects on WTP. Compared to face-to-face interviews, surveys conducted by the internet or telephone were more likely to have a significantly higher value of WTP per QALY, while out-of-pocket payment tended to lower the value. The prediction made for the province of Quebec, Canada, provided a QALY value of approximately USD $98,450 (CAD $127,985), which is about 2.3 times its gross domestic product (GDP) per capita in 2018. This study is consistent with the extant literature and will be useful for countries that do not yet have a preference-based survey for the value of a QALY.

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Acknowledgements

The authors are grateful to Pr. Jie He for her support.

Funding

This study was funded by Genome Canada. 2015 Large-Scale Applied Research Project Competition: Natural Resources and the Environment: Sector Challenges—Genomic Solutions.

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  1. Department of Economics, School of Business, University of Sherbrooke, Sherbrooke, Canada

    Christian R. C. Kouakou

  2. Centre de recherche de l’Institut universitaire en santé mentale de Montréal, CIUSSS de l’Est de l’Île de Montréal, Montreal, Canada

    Christian R. C. Kouakou & Thomas G. Poder

  3. Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, Canada

    Thomas G. Poder

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Appendix

Appendix

See Tables 7, 8.

Table 7 Bibliographic research methods on June 26, 2020
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Table 8 Estimation made with studies cluster standard errors
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Kouakou, C.R.C., Poder, T.G. Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression. Eur J Health Econ 23, 277–299 (2022). https://doi.org/10.1007/s10198-021-01364-3

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