Abstract
BackgroundThe payment card (PC) format and the open-ended (OE) format are common methods in eliciting willingness-to-pay (WTP) of one additional quality-adjusted life year (QALY). The aim of this research is to compare these two formats in eliciting the monetary value of a QALY.MethodsA contingent valuation survey was carried out using a pre-designed questionnaire with various hypothetical scenarios. The difference between the PC and the OE formats was evaluated by a two-sample equality test. Furthermore, generalized linear models were carried out to control observed heterogeneity and to test theoretical validity.ResultsIn total, 461 individuals were involved, among whom 235 (51%) answered the PC question, while 226 (49%) answered the OE question. Excluding zero response, the mean WTP values of these two formats for different scenarios varied dramatically, which was from 13,278 to 280,177 RMB for the PC, 18,119 to 620,913 RMB for the OE. The OE format tended to elicit lower values for less serious condition and higher values for more serious condition. However, equality test of mean and median demonstrated insignificant difference of these two formats for all scenarios. For both OE and PC format, most variables were found to have significant effect on the value of WTP/QALY. Moreover, joint estimation indicated a statistically significant positive effect on the OE results. Further analysis demonstrated that the imbalanced zero response distribution caused the main difference of these two formats.ConclusionsThis research indicated insignificantly different WTP/QALY estimates of the PC format and OE format with the grouped data whereas significantly higher estimates of the OE format from the pooled data. These two formats were found to be valid. More research about the difference and the validity of various WTP eliciting methods would be recommended for a robust estimation of WTP/QALY.
Highlights
The payment card (PC) format and the open-ended (OE) format are common methods in eliciting willingness-to-pay (WTP) of one additional quality-adjusted life year (QALY)
Demand-side methods are in line with the method taken in other public sectors as well as a welfarist approach, where the monetary value of one additional QALY is estimated as willingness-to-pay per QALY (WTP/Q) by contingent valuation (CV) surveys
We compared WTP/QALY estimates generated from the PC format and the OE format and found that the mean WTP values of these two formats varied dramatically for different scenarios and QALY gains
Summary
The payment card (PC) format and the open-ended (OE) format are common methods in eliciting willingness-to-pay (WTP) of one additional quality-adjusted life year (QALY). Budget allocation is one of the most prominent matters for decision makers in health-care systems today. One of the vital questions, related to the budget allocation, is how much health-care systems should spend on the. Demand-side methods are in line with the method taken in other public sectors as well as a welfarist approach, where the monetary value of one additional QALY is estimated as willingness-to-pay per QALY (WTP/Q) by contingent valuation (CV) surveys. CV is usually used to elicit monetary values of a nonmarket good or service [5] by requesting participants to state their willingness-to-pay (WTP) for obtaining a good, in this context, for QALY (always a small amount). Individuals have been asked about their WTP for health gains for which utility values were measured by EQ-5D population tariffs, Time-TradeOff, Standard Gamble or Visual Analogue Scale
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