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Valuing avoided morbidity using meta‐regression analysis: what can health status measures and QALYs tell us about WTP?

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  • George Van Houtven
  • John Powers
  • Amber Jessup
  • Jui‐Chen Yang

Abstract

Many economists argue that willingness‐to‐pay (WTP) measures are most appropriate for assessing the welfare effects of health changes. Nevertheless, the health evaluation literature is still dominated by studies estimating nonmonetary health status measures (HSMs), which are often used to assess changes in quality‐adjusted life years (QALYs). Using meta‐regression analysis, this paper combines results from both WTP and HSM studies applied to acute morbidity, and it tests whether a systematic relationship exists between HSM and WTP estimates. We analyze over 230 WTP estimates from 17 different studies and find evidence that QALY‐based estimates of illness severity – as measured by the Quality of Well‐Being (QWB) Scale – are significant factors in explaining variation in WTP, as are changes in the duration of illness and the average income and age of the study populations. In addition, we test and reject the assumption of a constant WTP per QALY gain. We also demonstrate how the estimated meta‐regression equations can serve as benefit transfer functions for policy analysis. By specifying the change in duration and severity of the acute illness and the characteristics of the affected population, we apply the regression functions to predict average WTP per case avoided. Copyright © 2006 John Wiley & Sons, Ltd.

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  • George Van Houtven & John Powers & Amber Jessup & Jui‐Chen Yang, 2006. "Valuing avoided morbidity using meta‐regression analysis: what can health status measures and QALYs tell us about WTP?," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 775-795, August.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:8:p:775-795
    DOI: 10.1002/hec.1105
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    as
    1. Johansson,Per-Olov, 1995. "Evaluating Health Risks," Cambridge Books, Cambridge University Press, number 9780521478786, January.
    2. Alberini, Anna & Krupnick, Alan, 1998. "Air Quality and Episodes of Acute Respiratory Illness in Taiwan Cities: Evidence from Survey Data," Journal of Urban Economics, Elsevier, vol. 44(1), pages 68-92, July.
    3. Amos Tversky & Daniel Kahneman, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1039-1061.
    4. Smith, V. Kerry & Osborne, Laura L., 1996. "Do Contingent Valuation Estimates Pass a "Scope" Test? A Meta-analysis," Journal of Environmental Economics and Management, Elsevier, vol. 31(3), pages 287-301, November.
    5. Dickie, Mark & Messman, Victoria L., 2004. "Parental altruism and the value of avoiding acute illness: are kids worth more than parents?," Journal of Environmental Economics and Management, Elsevier, vol. 48(3), pages 1146-1174, November.
    6. F. Reed Johnson & Melissa Ruby Banzhaf & William H. Desvousges, 2000. "Willingness to pay for improved respiratory and cardiovascular health: a multiple‐format, stated‐preference approach," Health Economics, John Wiley & Sons, Ltd., vol. 9(4), pages 295-317, June.
    7. Bleichrodt, Han & Quiggin, John, 1999. "Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis?," Journal of Health Economics, Elsevier, vol. 18(6), pages 681-708, December.
    8. Richard C. Ready & Ståle Navrud & RW. Richard Dubourg, 2001. "How Do Respondents with Uncertain Willingness to Pay Answer Contingent Valuation Questions?," Land Economics, University of Wisconsin Press, vol. 77(3), pages 315-326.
    9. Emma J. Frew & David K. Whynes & Jane L. Wolstenholme, 2003. "Eliciting Willingness to Pay: Comparing Closed-Ended with Open-Ended and Payment Scale Formats," Medical Decision Making, , vol. 23(2), pages 150-159, March.
    10. Zarkin, G.A. & Dean, N. & Mauskopf, J.A. & Williams, R., 1993. "Potential health benefits of nutrition label changes," American Journal of Public Health, American Public Health Association, vol. 83(5), pages 717-724.
    11. R. K. Blamey & J. W. Bennett & M. D. Morrison, 1999. "Yea-Saying in Contingent Valuation Surveys," Land Economics, University of Wisconsin Press, vol. 75(1), pages 126-141.
    12. V. Smith & Subhrendu Pattanayak, 2002. "Is Meta-Analysis a Noah's Ark for Non-Market Valuation?," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 22(1), pages 271-296, June.
    13. Mohan V. Bala & Gary A. Zarkin, 2000. "Are QALYs an appropriate measure for valuing morbidity in acute diseases?," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 177-180, March.
    14. Holmes Thomas P. & Kramer Randall A., 1995. "An Independent Sample Test of Yea-Saying and Starting Point Bias in Dichotomous-Choice Contingent Valuation," Journal of Environmental Economics and Management, Elsevier, vol. 29(1), pages 121-132, July.
    15. Alan Diener & Bernie O'Brien & Amiram Gafni, 1998. "Health care contingent valuation studies: a review and classification of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 313-326, June.
    16. David M. Cutler & Elizabeth Richardson, 1997. "Measuring the Health of the U.S. Population," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 28(1997 Micr), pages 217-282.
    17. Johansson,Per-Olov, 1995. "Evaluating Health Risks," Cambridge Books, Cambridge University Press, number 9780521472852, January.
    18. Lauraine G. Chestnut & L. Robin Keller & William E. Lambert & Robert D. Rowe, 1996. "Measuring Heart Patients' Willingness to Pay for Changes in Angina Symptoms," Medical Decision Making, , vol. 16(1), pages 65-76, February.
    19. Bernt Kartman & Fredrik Andersson & Magnus Johannesson, 1996. "Willingness to Pay for Reductions in Angina Pectoris Attacks," Medical Decision Making, , vol. 16(3), pages 248-253, August.
    20. Sujitra Vassanadumrongdee & Shunji Matsuoka & Hiroaki Shirakawa, 2004. "Meta-analysis of contingent valuation studies on air pollution-related morbidity risks," Environmental Economics and Policy Studies, Springer;Society for Environmental Economics and Policy Studies - SEEPS, vol. 6(1), pages 11-47, March.
    21. Ryan, Mandy & Scott, David A. & Donaldson, Cam, 2004. "Valuing health care using willingness to pay: a comparison of the payment card and dichotomous choice methods," Journal of Health Economics, Elsevier, vol. 23(2), pages 237-258, March.
    22. McConnell, K. E., 1997. "Does Altruism Undermine Existence Value?," Journal of Environmental Economics and Management, Elsevier, vol. 32(1), pages 22-37, January.
    23. Ståle Navrud, 2001. "Valuing Health Impacts from Air Pollution in Europe," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 20(4), pages 305-329, December.
    24. Harrington, Winston & Portney, Paul R., 1987. "Valuing the benefits of health and safety regulation," Journal of Urban Economics, Elsevier, vol. 22(1), pages 101-112, July.
    25. Loehman, E. T. & Berg, S. V. & Arroyo, A. A. & Hedinger, R. A. & Schwartz, J. M. & Shaw, M. E. & Fahien, R. W. & De, V. H. & Fishe, R. P. & Rio, D. E., 1979. "Distributional analysis of regional benefits and cost of air quality control," Journal of Environmental Economics and Management, Elsevier, vol. 6(3), pages 222-243, September.
    26. Johansson, Per-Olov, 1994. "Altruism and the value of statistical life: Empirical implications," Journal of Health Economics, Elsevier, vol. 13(1), pages 111-118, March.
    27. Thomas Klose, 2003. "A utility‐theoretic model for QALYs and willingness to pay," Health Economics, John Wiley & Sons, Ltd., vol. 12(1), pages 17-31, January.
    28. Alberini, Anna & Cropper, Maureen & Fu, Tsu-Tan & Krupnick, Alan & Liu, Jin-Tan & Shaw, Daigee & Harrington, Winston, 1997. "Valuing Health Effects of Air Pollution in Developing Countries: The Case of Taiwan," Journal of Environmental Economics and Management, Elsevier, vol. 34(2), pages 107-126, October.
    29. Jhonson, F. Reed & Fries, Erin E. & Banzhaf, H. Spencer, 1997. "Valuing morbidity: An integration of the willingness-to-pay and health-status index literatures," Journal of Health Economics, Elsevier, vol. 16(6), pages 641-665, December.
    30. Rick L. Williams, 2000. "A Note on Robust Variance Estimation for Cluster-Correlated Data," Biometrics, The International Biometric Society, vol. 56(2), pages 645-646, June.
    31. T. D. Stanley, 2001. "Wheat from Chaff: Meta-analysis as Quantitative Literature Review," Journal of Economic Perspectives, American Economic Association, vol. 15(3), pages 131-150, Summer.
    32. Jan Abel Olsen & Richard D. Smith, 2001. "Theory versus practice: a review of ‘willingness‐to‐pay’ in health and health care," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 39-52, January.
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    2. Rheinberger, Christoph M. & Hammitt, James K., 2014. "The welfare value of FDA's mercury-in-fish advisory: A dynamic reanalysis," Journal of Health Economics, Elsevier, vol. 37(C), pages 113-122.
    3. James Hammitt, 2013. "Admissible utility functions for health, longevity, and wealth: integrating monetary and life-year measures," Journal of Risk and Uncertainty, Springer, vol. 47(3), pages 311-325, December.
    4. Kevin Boyle & Sapna Kaul & Ali Hashemi & Xiaoshu Li, 2015. "Applicability of benefit transfers for evaluation of homeland security counterterrorism measures," Chapters, in: Carol Mansfield & V. K. Smith (ed.), Benefit–Cost Analyses for Security Policies, chapter 10, pages 225-253, Edward Elgar Publishing.
    5. Mehmet Kutluay & Roy Brouwer & Richard S. J. Tol, 2019. "Valuing malaria morbidity: results from a global meta-analysis," Journal of Environmental Economics and Policy, Taylor & Francis Journals, vol. 8(3), pages 301-321, July.
    6. Hammitt, James & Haninger, Kevin, 2011. "Valuing Morbidity Risk: Willingness to Pay per Quality-Adjusted Life Year," LERNA Working Papers 11.09.343, LERNA, University of Toulouse.
    7. Moeltner Klaus & Rosenberger Randall S, 2008. "Predicting Resource Policy Outcomes via Meta-Regression: Data Space, Model Space, and the Quest for 'Optimal Scope'," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(1), pages 1-31, August.
    8. Robinson Lisa A. & Hammitt James K., 2013. "Skills of the trade: valuing health risk reductions in benefit-cost analysis," Journal of Benefit-Cost Analysis, De Gruyter, vol. 4(1), pages 107-130, March.
    9. Ana Bobinac & Job Exel & Frans Rutten & Werner Brouwer, 2014. "The Value of a QALY: Individual Willingness to Pay for Health Gains Under Risk," PharmacoEconomics, Springer, vol. 32(1), pages 75-86, January.
    10. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    11. John McKie & Bradley Shrimpton & Jeff Richardson & Rosalind Hurworth, 2011. "The monetary value of a life year: evidence from a qualitative study of treatment costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 945-957, August.
    12. Stein, Alexander J. & Meenakshi, J.V. & Qaim, Matin & Nestel, Penelope & Sachdev, H.P.S. & Bhutta, Zulfiqar A., 2008. "Potential impacts of iron biofortification in India," Social Science & Medicine, Elsevier, vol. 66(8), pages 1797-1808, April.
    13. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.
    14. Zhuanlan Sun & Demi Zhu, 2019. "Exposure to outdoor air pollution and its human health outcomes: A scoping review," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-18, May.
    15. Tracy Lieu & G. Ray & Ismael Ortega-Sanchez & Ken Kleinman & Donna Rusinak, 2009. "Willingness to Pay for a QALY Based on Community Member and Patient Preferences for Temporary Health States Associated with Herpes Zoster," PharmacoEconomics, Springer, vol. 27(12), pages 1005-1016, December.
    16. Hammitt, James K. & Haninger, Kevin, 2017. "Valuing nonfatal health risk as a function of illness severity and duration: Benefit transfer using QALYs," Journal of Environmental Economics and Management, Elsevier, vol. 82(C), pages 17-38.
    17. Bobinac, Ana & van Exel, N. Job A. & Rutten, Frans F.H. & Brouwer, Werner B.F., 2012. "GET MORE, PAY MORE? An elaborate test of construct validity of willingness to pay per QALY estimates obtained through contingent valuation," Journal of Health Economics, Elsevier, vol. 31(1), pages 158-168.

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