Department of Economics, School of Business, University of Sherbrooke, Sherbrooke, Canada.
Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l'Est de l'Île de Montréal, Montréal, Canada.
Eur J Health Econ. 2024 Jul;25(5):787-811. doi: 10.1007/s10198-023-01625-3. Epub 2023 Sep 1.
The value of a Quality-Adjusted Life-Year (QALY) is of great importance for the healthcare system. It helps when it comes to defining a cost-effectiveness threshold for the evaluation of health technologies. No willingness-to-pay value for a QALY exists in the province of Quebec, Canada.
In this paper, we empirically investigated the monetary value of a QALY for the population of Quebec.
Based on the Short-Form 6-Dimension version 2 (SF-6Dv2), we conducted an online survey with a representative adult sample living in Quebec. We used a time trade-off (TTO) combined with contingent valuation (CV), and a discrete choice experiment (DCE) to assess both the population's willingness to pay (WTP) for one QALY and the marginal WTP for health attributes. A health utility algorithm using hybrid regression was developed to determine a preference-based value set for health states.
Main analysis was conducted on 993 answers for the CV and 2143 answers for the DCE. The willingness-to-pay per QALY varied from CA$ 47,048.84 (CI: 21,554.38; 72,543.30) for CV to CA$ 73,936.87 (CI: 63,105.40; 84,768.35) for DCE. Among the 6 dimensions of the SF-6Dv2, marginal WTP varied from CA$ 4499.15 (CI: 2975.06; 6023.25) for more role accomplishment in daily activities to CA$ 15,867.12 (CI: 13,825.75; 17,908.49) for less pain. Robustness check with multiple alternative samples, as well as alternative health utility algorithms, showed that the results were robust and the DCE method provided 50% larger results than the CV method, although confidence intervals overlap.
This paper provides useful information for decision-makers on the monetary value of a QALY in Quebec.
质量调整生命年（QALY）的价值对于医疗保健系统非常重要。它有助于确定卫生技术评估的成本效益阈值。加拿大魁北克省没有 QALY 的支付意愿价值。
本文旨在对魁北克省人群的 QALY 货币价值进行实证研究。
基于简短的 6 维度问卷 2 版（SF-6Dv2），我们对居住在魁北克的代表性成年样本进行了在线调查。我们使用时间权衡（TTO）结合条件价值评估（CV）和离散选择实验（DCE）来评估人群对一个 QALY 的支付意愿（WTP）和健康属性的边际 WTP。开发了一种使用混合回归的健康效用算法来确定健康状况的偏好价值集。
主要分析共纳入了 993 份 CV 和 2143 份 DCE 的答案。CV 法的 QALY 支付意愿从 47048.84 加元（95%置信区间：21554.38；72543.30）到 DCE 法的 73936.87 加元（95%置信区间：63105.40；84768.35）不等。在 SF-6Dv2 的 6 个维度中，边际 WTP 从日常活动中更多的角色成就（4499.15 加元，95%置信区间：2975.06；6023.25）到更少的疼痛（15867.12 加元，95%置信区间：13825.75；17908.49）不等。使用多个替代样本和替代健康效用算法进行稳健性检查表明，结果是稳健的，DCE 方法提供的结果比 CV 方法大 50%，尽管置信区间重叠。
本文为魁北克省 QALY 货币价值的决策者提供了有用的信息。
