Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis
Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis
复制标题
DOI：
10.1177/0272989x05282638
复制
发表时间：
2005-11-01
影响因子：
3.6
通讯作者：
Suarez-Almazor, ME
中科院分区：
文献类型：
--
作者：
Byrne, MM;O'Malley, K;Suarez-Almazor, ME
背景。确定特定的医疗干预措施是否具有成本效益需要建立每项收益的成本阈值。随着关于适当阈值的争论仍在继续，我们提出了每个质量调整生命年 (QALY) 的支付意愿 (WTP) 衡量标准，以衡量自身健康和 2 种假设的骨关节炎情景。方法。通过随机数字拨号找到德克萨斯州哈里斯县的 193 个人，使用视觉模拟量表、时间权衡、标准赌博和 WTP 方法完成了面对面访谈，收集人口统计信息和健康偏好。结果。所有方法的平均 WTP/QALY 均低于（范围为 1221-5690 美元/QALY），低于显示偏好研究的许多估计值，也低于经常引用的任意截止值 50 000 美元。当参与者判断其个人健康改善情况而不是假设情景时，WTP/QALY 最高。对于某些场景，不同的启发方法的 WTP/QALY 存在一些显着差异。人口统计特征与 WTP/QALY 指标无关。结论。与之前评估 WTP/QALY 的许多情况不同，此处评估的健康状况和健康改善不包含死亡风险。此处发现的较低 WTP/QALY 值可能表明死亡风险降低的存在大大增加了所述 WTP/QALY 成本效益的适当阈值可能取决于情况的背景，包括死亡风险。
Background. Determining whether a particular medical intervention is cost-effective requires that a threshold of cost per benefit gained be established. As debate continues over the appropriate threshold, we present measures of willingness to pay (WTP) per quality-adjusted life year (QALY)for own health and 2 hypothetical osteoarthritis scenarios. Methods. One hundred ninety-three persons, located through random digit dialing in Harris County, Texas, completed face-to-face interviews collecting demographic information and health preferences using visual analog scale, time tradeoff, standard gamble, and WTP methodologies. Results. The mean WTP/QALY for all methods was lower (range, $1221-$5690/QALY) than many estimates from revealed preference studies and lower than the oft-cited arbitrary cutoff of $50 000. WTP/QALY was highest when participants were judging their personal health improvements as opposed to hypothetical scenarios. There were some significant differences in WTP/QALY across elicitation methodologies for the some scenario. Demographic characteristics were not associated with WTP/QALY measures. Conclusions. The health states and improvements in health evaluated here do not contain a risk of mortality, unlike many situations in which WTP/QALY has been previously evaluated, The lower WTP/QALY values found here may indicate that the presence of a mortality risk reduction substantially increases stated WTP/QALY Appropriate thresholds for cost-effectiveness maybe dependent on the context of a situation, including risk of mortality.