The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Ulf Gerdtham. Photo.

Ulf Gerdtham

Professor

Ulf Gerdtham. Photo.

Measuring the end-of-life premium in cancer using individual ex ante willingness to pay

Author

  • S. Olofsson
  • U. G. Gerdtham
  • L. Hultkrantz
  • U. Persson

Summary, in English

For the assessment of value of new therapies in healthcare, Health Technology Assessment (HTA) agencies often review the cost per quality-adjusted life-year (QALY) gained. Some HTA agencies accept a higher cost per QALY gained when treatment is aimed at prolonging survival for patients with a short expected remaining lifetime, a so-called end-of-life (EoL) premium. The objective of this study is to elicit the existence and size of an EoL premium in cancer. Data was collected from 509 individuals in the Swedish general population 20–80 years old using a web-based questionnaire. Preferences were elicited using subjective risk estimation and the contingent valuation (CV) method. A split-sample design was applied to test for order bias. The mean value of a QALY was MSEK4.8 (€528,000), and there was an EoL premium of 4–10% at 6 months of expected remaining lifetime. Using subjective risk resulted in more robust and valid estimates of the value of a QALY. Order of scenarios did not have a significant impact on the WTP and the result showed scale sensitivity. Our result provides some support for the use of an EoL premium based on individual preferences when expected remaining lifetime is short and below 24 months. Furthermore, we find support for a value of a QALY that is above the current threshold of several HTA agencies.

Department/s

  • Health Economics
  • EpiHealth: Epidemiology for Health

Publishing year

2018-07

Language

English

Pages

807-820

Publication/Series

European Journal of Health Economics

Volume

19

Issue

6

Document type

Journal article

Publisher

Springer

Topic

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • Cancer
  • Contingent valuation
  • End of life
  • Individual preferences
  • Value of a QALY
  • Willingness to pay

Status

Published

Research group

  • Health Economics

ISBN/ISSN/Other

  • ISSN: 1618-7598