Willingness-to-Pay for One Quality-Adjusted Life-Year: A Population-Based Study from Iran

OBJECTIVE: This study was aimed at estimating the value of the general population's willingness-to-pay (WTP) for one quality-adjusted life-year (QALY) in Iran. METHODS: Using multistage randomized cluster sampling, we recruited and interviewed 651 adult residents of Shiraz, south Iran. The mean age of the interviewees was 43.9 ± 16.3 years, and 326 (50.1%) of them were male. To each interviewee, we presented one of the hypothetical health scenarios that were used in the European value of a QALY project. Questionnaires, which were validated for the Persian language, were administered in digitally-assisted format, and a gray block questionnaire was used for special cases. The data were then analyzed using STATA and SPSS. RESULTS: The overall mean value of payment for one QALY of respondents who expressed WTP was US$2847, which is equal to 0.57 of the GDP per capita of Iran's population. Under the end-of-life (terminal illness) scenario, this value was 13% higher than health-gain scenarios. WTP was also associated with high educational level, household income, and household expenditure. CONCLUSION: Our results provided a threshold range of WTP and insights into rigorous scientific decision making about healthcare technology for the future