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Eliciting the Monetary Value of a Quality-Adjusted Life Year in a Greek Outpatient Department in Times of Economic Austerity

Titulo Eliciting the Monetary Value of a Quality-Adjusted Life Year in a Greek Outpatient Department in Times of Economic Austerity
Autoría Mavrodi A, Aletras V, Spanou A, Niakas D.
Fuente Pharmacoecon Open. 2017 Dec;1(4):291-300. doi: 10.1007/s41669-017-0033-4.
Resumen BACKGROUND AND OBJECTIVE: Contingent valuation is widely used to determine individuals' willingness to pay (WTP) for a health gain. Our study aimed to elicit an empirical estimate of the monetary value of a quality-adjusted life year (QALY) in a Greek outpatient setting in times of economic austerity and assess the impact of patients' characteristics on their valuations. METHODS: We used a questionnaire as a survey tool to determine the maximum WTP for a health gain of a hypothetical therapy and to evaluate patients' health-related quality of life (EuroQoL-5D-3L) and demographic and socioeconomic characteristics. EuroQoL tariffs were used to estimate health utilities. Mean WTP values were computed and ordinary least squares regressions performed on transformed Box-Cox and logarithmic dependent WTP per QALY variables to remedy observed skewness problems. RESULTS: Analyses were performed for 167 patients with utility values less than unity. Mean WTP per QALY reported was similar for both payment vehicles examined: payments made out-of-pocket (€2629) and payments made through new tax imposition (€2407). Regression results showed that higher net monthly family income was associated with higher WTP per QALY for both payment vehicles. Moreover, the presence of a chronic condition and higher level of education were associated with higher out-of-pocket WTP per QALY and WTP per QALY through taxes, respectively. CONCLUSION: The very low WTP per QALY estimates could be explained by the recent severe economic depression and austerity in Greece. In fact, family income was found to be a significant predictor of WTP per QALY. Since these estimates deviate significantly from the cost-effectiveness thresholds still employed in economic evaluations in this country, research should be undertaken promptly to further examine this important issue using a nationwide representative sample of the general population along with WTP and other methodologies.
URL www.ncbi.nlm.nih.gov/pubmed/29441505