An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran
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Cost Effectiveness and Resource Allocation Open Access
RESEARCH
An exploratory study to estimate cost‑effectiveness threshold value for life saving treatments in western Iran Najmeh Moradi1, Abraha Woldemichael2, Parisa Malekian3, Delnia Moradi Rotvandi3 and Satar Rezaei4*
Abstract Background: Cost-effectiveness analysis provides a crucial means for evidence-informed decision-making on resource allocation. This study aims to elicit individuals’ willingness to pay (WTP) for one additional quality-adjusted life-year (QALY) gained from life-saving treatment and associated factors in Kermanshah city, western Iran. Methods: We conducted a cross-sectional study on a total of 847 adults aged 18 years and above to elicit their WTP for one additional QALY gained by oneself and a family member using a hypothetical life-saving treatment. We used a multistage sampling technique to select the samples, and the Iranian version of EQ-5D-3L, and visual analogue scale (VAS) measures to obtain the participants’ health utility value. The Tobit regression model was used to identify the factors affecting WTP per QALY values. Results: The mean WTP value and standard deviation (SD) was US$ 862 (3,224) for the respondents. The mean utility values using EQ-5D-3L and VAS methods for respondents were 0.779 and 0.800, respectively. Besides, the WTP for the additional QALY gained by the individual participants using the EQ-5D-3L and VAS methods were respectively US$ 1,202 and US$ 1,101, while the estimated value of the family members was US$ 1,355 (SD = 3,993). The Tobit regression models indicated that monthly income, education level, sex, and birthplace were statistically significantly associated (p 0 if a family member faced the risk of death (Fig. 1). Around 53% of the participants would have a WTP value of zero if they would encounter a lifethreatening condition, and 28% would have a WTP value of zero if a family member would faced a life-threatening situation. In the mid-range of the bid values, the tendency towards paying for the family members was higher, but in the upper bid values, the participants showed similar behavior. Despite a higher tendency to pay for a family member to save a life, there was not a significant difference in the WTP pattern. The findings indicated that 75% of the respondents had the WTP value of less than US$ 155 for themselves, and 59% had the same WTP value as their family members. Only 2% of the participants had the WTP value of as high as US$19,381 (Fig. 2).
Results A total sample of 847 adult Iranians aged 18 years and above living in Kermanshah city participated in the study. The mean age of the participants was 33.6 years, with a standard deviation (± SD) of 12.1 years, and male and female participants accounted for 45.4% and 54.6%, respectively (Table 1). One-hundred and forty-eight of the respondents (17.5%) had a monthly income of less than US$ 78, while 158 (18.6%) had more than US$ 310 (US$ 1 = IRR 128,986). Nearly 19% of the respondents had chronic diseases, 15.2% had a history of the de
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