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      Monetary Value of Quality-Adjusted Life Years (QALY) among Patients with Cardiovascular Disease: a Willingness to Pay Study (WTP)

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          Abstract

          The aim of this study was to estimate the monetary value of a QALY among patients with heart disease and to identify its determinants. A cross-sectional survey was conducted through face-to-face interview on 196 patients with cardiovascular disease from two heart hospitals in Tehran, Iran, to estimate the value of QALY using disaggregated and aggregated approaches. The EuroQol-5 Dimension (EQ-5D) questionnaire, Visual Analogue Scale (VAS), Time Trade-Off (TTO) and contingent valuation WTP techniques were employed, first to elicit patients’ preferences and then, to estimate WTP for QALY. The association of patients’ characteristics with WTP for QALY, was assessed through Heckman selection model. The Mean willingness to pay per QALY, estimated by the disaggregated approach ranged from 2,799 to 3599 US dollars. It is higher than the values, estimated from aggregated methods (USD 2,256 to 3,137). However, in both approaches, the values were less than one Gross Domestic Product (GDP) per capita of Iran.

          Significant variables were: Current health state, education, age, marital status, number of comorbidities, and household’s cost group. Our results challenge two major issues: the first, is a policy challenge which concerns the WHO recommendation to use less than 3 GDP per capita as a cost-effectiveness threshold value. The second, is an analytical challenge related to patients with zero QALY gain. More scrutiny is suggested on the issue of how patients with full health state valuation should be dealt with and what arbitrary value could be included in the estimation value of QALY when the disaggregated approach used.

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          Most cited references33

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          QALYs: the basics.

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            Statistical Efficiency of Double-Bounded Dichotomous Choice Contingent Valuation

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              Global status report on noncommunicable diseases 2010

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                Author and article information

                Journal
                Iran J Pharm Res
                Iran J Pharm Res
                IJPR
                Iranian Journal of Pharmaceutical Research : IJPR
                Shaheed Beheshti University of Medical Sciences (Tehran, Iran )
                1735-0328
                1726-6890
                Spring 2017
                : 16
                : 2
                : 823-833
                Affiliations
                [a ] School of Pharmacy ,Shahid Beheshti University of medical sciences, Tehran, Iran.
                [b ] School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
                [c ] School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
                [d ] Health Economics Department, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
                [e ] cardiovascular research center, Shahid Beheshti University of medical sciences, Tehran, Iran.
                [f ] Economics Faculty, Allameh Tabatabaei University, Tehran Iran.
                Author notes
                [* ]Corresponding author: E-mail: hrasekh@gmail.com
                Article
                ijpr-16-823
                5603894
                28979338
                8cbe8987-535f-416f-bd52-863bc88c7ca6
                © 2017 by School of Pharmacy, Shaheed Beheshti University of Medical Sciences and Health Services

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : September 2015
                : June 2016
                Categories
                Original Article

                willingness to pay,quality-adjusted life year,contingent valuation method,cost -effectiveness threshold value,cardiovascular diseases

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