The value of health and well-being from a societal perspective: A willingness to pay experiment in the Netherlands.

Abstract

Interpreting the results of cost-effectiveness analyses requires a threshold value for the costs per quality-adjusted life year (QALY). The first empirical studies that estimated this threshold value from a societal perspective in the Netherlands were conducted 10 years ago. This paper is aimed at estimating the social willingness to pay (WTP) per QALY and per well-being adjusted life year (WALY); investigating how the societal value of a QALY changed over the course of about ten years and comparing the WTP for well-being relative to health from a societal perspective. In this study, the contingent valuation approach was used, in which QALYs and WALYs were valued under uncertainty and corrected for probability weighting. The estimates obtained in a representative sample of the Dutch population ranged from €27,800 to €95,300 per QALY, depending on the specification of the societal perspective. The value of health found in the SOC and SII versions of this study, nominally, were between 6.1% and 33.4% higher than the values found 10 years ago. Moreover, the estimates per WALY ranged from €88,500 to €349,500. Finally, our results show that a year in full well-being was valued between 2.95 and 4.35 times higher than a year in full health.