Willingness to pay for quality and length of life gains in end of life patients of different ages

Vivian Reckers-Droog; Job van Exel; Werner Brouwer

doi:10.1016/j.socscimed.2021.113987

Willingness to pay for quality and length of life gains in end of life patients of different ages

Vivian Reckers-Droog^*, Job van Exel, Werner Brouwer

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Health gains are increasingly weighted in economic evaluations of new health technologies to guide resource-allocation decisions in healthcare. In Norway and the Netherlands weights are, for example, based on the disease severity of patients. In England and Wales, a higher weight is attached to quality-adjusted life-years (QALYs) gained from life-extending end-of-life (EOL) treatments. Societal preferences for QALY gains in EOL patients are increasingly examined. Although the available evidence suggests that gains in health-related quality of life (QOL) may be preferred to gains in life expectancy (LE), little is known about the influence of EOL patients’ age on these preferences. In this study, we examine the willingness to pay (WTP) for QOL and LE gains in EOL patients of different ages in a sample (n = 803) of the general public in the Netherlands. We found that WTP was relatively higher for QOL and LE gains in younger EOL patients. We further found indications suggesting that WTP may be relatively higher for QOL gains at the EOL, except for patients aged 20 for whom we observed a higher WTP for LE gains. Our results may inform discussions on attaching differential weights to QOL and LE gains in EOL patients of different ages with the objective to better align resource-allocation decisions with societal preferences.

Original language	English
Article number	113987
Number of pages	6
Journal	Social Science and Medicine
Volume	279
Early online date	4 May 2021
DOIs	https://doi.org/10.1016/j.socscimed.2021.113987
Publication status	Published - Jun 2021

Bibliographical note

Funding Information:
This study is part of a larger project examining the broader societal benefits of healthcare and was funded by a consortium of GlaxoSmithKline , AbbVie , and AstraZeneca in the Netherlands. The funders had no role in the study design, data collection and analysis, interpretation of the data, preparation of the manuscript, and/or decision to submit for publication. The views expressed in this article are those of the authors.

Publisher Copyright:
© 2021 The Author(s)

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10.1016/j.socscimed.2021.113987

1-s2.0-S0277953621003191-mainLicence: CC BY

Cite this

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title = "Willingness to pay for quality and length of life gains in end of life patients of different ages",

abstract = "Health gains are increasingly weighted in economic evaluations of new health technologies to guide resource-allocation decisions in healthcare. In Norway and the Netherlands weights are, for example, based on the disease severity of patients. In England and Wales, a higher weight is attached to quality-adjusted life-years (QALYs) gained from life-extending end-of-life (EOL) treatments. Societal preferences for QALY gains in EOL patients are increasingly examined. Although the available evidence suggests that gains in health-related quality of life (QOL) may be preferred to gains in life expectancy (LE), little is known about the influence of EOL patients{\textquoteright} age on these preferences. In this study, we examine the willingness to pay (WTP) for QOL and LE gains in EOL patients of different ages in a sample (n = 803) of the general public in the Netherlands. We found that WTP was relatively higher for QOL and LE gains in younger EOL patients. We further found indications suggesting that WTP may be relatively higher for QOL gains at the EOL, except for patients aged 20 for whom we observed a higher WTP for LE gains. Our results may inform discussions on attaching differential weights to QOL and LE gains in EOL patients of different ages with the objective to better align resource-allocation decisions with societal preferences.",

author = "Vivian Reckers-Droog and {van Exel}, Job and Werner Brouwer",

note = "Funding Information: This study is part of a larger project examining the broader societal benefits of healthcare and was funded by a consortium of GlaxoSmithKline , AbbVie , and AstraZeneca in the Netherlands. The funders had no role in the study design, data collection and analysis, interpretation of the data, preparation of the manuscript, and/or decision to submit for publication. The views expressed in this article are those of the authors. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

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AU - Brouwer, Werner

N1 - Funding Information: This study is part of a larger project examining the broader societal benefits of healthcare and was funded by a consortium of GlaxoSmithKline , AbbVie , and AstraZeneca in the Netherlands. The funders had no role in the study design, data collection and analysis, interpretation of the data, preparation of the manuscript, and/or decision to submit for publication. The views expressed in this article are those of the authors. Publisher Copyright: © 2021 The Author(s)

PY - 2021/6

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N2 - Health gains are increasingly weighted in economic evaluations of new health technologies to guide resource-allocation decisions in healthcare. In Norway and the Netherlands weights are, for example, based on the disease severity of patients. In England and Wales, a higher weight is attached to quality-adjusted life-years (QALYs) gained from life-extending end-of-life (EOL) treatments. Societal preferences for QALY gains in EOL patients are increasingly examined. Although the available evidence suggests that gains in health-related quality of life (QOL) may be preferred to gains in life expectancy (LE), little is known about the influence of EOL patients’ age on these preferences. In this study, we examine the willingness to pay (WTP) for QOL and LE gains in EOL patients of different ages in a sample (n = 803) of the general public in the Netherlands. We found that WTP was relatively higher for QOL and LE gains in younger EOL patients. We further found indications suggesting that WTP may be relatively higher for QOL gains at the EOL, except for patients aged 20 for whom we observed a higher WTP for LE gains. Our results may inform discussions on attaching differential weights to QOL and LE gains in EOL patients of different ages with the objective to better align resource-allocation decisions with societal preferences.

AB - Health gains are increasingly weighted in economic evaluations of new health technologies to guide resource-allocation decisions in healthcare. In Norway and the Netherlands weights are, for example, based on the disease severity of patients. In England and Wales, a higher weight is attached to quality-adjusted life-years (QALYs) gained from life-extending end-of-life (EOL) treatments. Societal preferences for QALY gains in EOL patients are increasingly examined. Although the available evidence suggests that gains in health-related quality of life (QOL) may be preferred to gains in life expectancy (LE), little is known about the influence of EOL patients’ age on these preferences. In this study, we examine the willingness to pay (WTP) for QOL and LE gains in EOL patients of different ages in a sample (n = 803) of the general public in the Netherlands. We found that WTP was relatively higher for QOL and LE gains in younger EOL patients. We further found indications suggesting that WTP may be relatively higher for QOL gains at the EOL, except for patients aged 20 for whom we observed a higher WTP for LE gains. Our results may inform discussions on attaching differential weights to QOL and LE gains in EOL patients of different ages with the objective to better align resource-allocation decisions with societal preferences.

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Willingness to pay for quality and length of life gains in end of life patients of different ages

Abstract

Bibliographical note

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