Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
BMC Health Serv Res. 2021 Dec 14;21(1):1339. doi: 10.1186/s12913-021-07344-w.
Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran's general public, the cost-effectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting.
We have measured this cost-effectiveness threshold with the participation of 2854 individuals from five provinces, each representing an income quintile, using a modified Time Trade-Off-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire.
Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confirmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts.
In the health system of Iran, any intervention that is with the incremental cost-effectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-effective.
由于缺乏基于伊朗普通公众偏好的每额外获得一个质量调整生命年的意愿支付意愿，卫生系统干预措施的成本效益尚不清楚，这使得将经济评估应用于卫生资源优先排序具有挑战性。
我们使用经过修正的基于时间权衡的链式方法，让来自五个省份的 2854 名参与者参与，衡量了这一成本效益阈值。在这个基于在线的实证调查中，为了提取健康效用值，参与者被随机分配到两个绿色（21121）和黄色（22222）健康情景中的一个，这两个情景是基于之前验证过的 EQ-5D-3L 问卷设计的。
在这两种健康状况版本中，一轮 QALY 增益的平均值（四舍五入）分别为 6740 美元至 7400 美元和 6480 美元至 7120 美元，适用于总模型和修剪模型，这分别相当于人均 GDP 的 1.35 倍至 1.18 倍。对数线性多元 OLS 回归分析证实，如果受访者的收入、不舒适和教育水平高于其同行，他们更有可能支付。
在伊朗的卫生系统中，任何增量成本效益比等于或低于 7402.12 美元的干预措施都将被认为是具有成本效益的。
