Willingness-to-pay in health economics: International comparison survey in east Asian countries.

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To examine the relationship between severity of health status and monetary value of a QALY, we obtained willingness to pay (WTP) values for one additional QALY in eight patterns of health states. We randomly sampled approximately 2,100 respondents from an online panel. We randomly allocated respondents to two of 14 questionnaires, with 300 responses expected for each pattern. After respondents were asked whether they wanted to purchase the treatment, double-bounded dichotomous choice method was used to obtain WTP values. The results clearly show that the WTP per QALY is higher for worse health states than for better health states. The WTP per QALY ranged from JPY 1.5 million to 5 million. For respondents who wanted to purchase the treatment, WTP values were significantly correlated with household income. This survey shows that QALY doesn’t necessarily have the same monetary value. Given these results, the WTP per QALY depends on the severity of health states.