Original Title: Disposición a pagar de la sociedad espańola por un ańo de vida ajustado por calidad

Authors' objectives: The aim of this report is to estimate the society willingness to pay (WTP) for a QALY in Spain.

Authors' results and conclusions: RESULTS: We obtained 2,003 responses collected between December 2016 and January 2017. Regression models showed the expected sign and statistical significance. WTP values for a QALY estimated according to our analysis varied from 10,000€ to 30,000€, depending on the level of severity and the health dimension being affected. We observe that there is not a unique WTP value for a QALY. The estimation varies substantially according to the type of health gain and dimension that is shown to respondents. Moderate health problems were associated to significantly higher WTP for a QALY values than those derived from severe problems. This finding suggests that there is not linearity between severity and WTP. On the other hand, health problems affecting mobility, self-care and, in the case of severe problems, pain, were associated to higher WTP values than those affecting usual activities and anxiety/depression. These variations were, however, not statistically significantly different. CONCLUSIONS: This report has provided a set of WTP values for a QALY in Spain. Our findings suggest that there is not a unique value, and this requires an in depth analysis of the reasons for the observed variations. The mean estimates according to the monetary value of a QALY computed in this report are, nonetheless, very similar to those estimated according to the opportunity cost perspective. Therefore, we recommend to use the same CE threshold, valued in 20,000-25,000€, both in situations requiring disinvestment within the health system as well as in situations where the opportunity cost falls outside the health care sector. We recommend to further explore the differences observe in the social value of a QALY estimations to assess the feasibility of incorporating such information in setting cost-effectiveness thresholds in contexts where disinvestment is not required.

Authors' methods: The methods used relied on the design and implementation of an online survey to obtain declared preferences of a large and representative sample of the Spanish population, as well as econometric methods for the estimation of the monetary value for a QALY according to this population. We follow three steps: 1) the elicitation of health gains in terms of QALYs by a means of a Discrete Choice Experiment (DCE) and an exercise of time trade-off (TTO); 2) the estimation of the WTP for these health gains using a WTP survey, and 3) the aggregation of both estimations to yield the monetary value of a QALY according to different types of health gains.

Project Status: Completed

Year Published: 2016

URL for published report: https://sescs.es/disposicion-a-pagar-de-la-sociedad-espanola-por-un-ano-de-vida-ajustado-por-calidad/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es