1. Determination of Cost-Effectiveness Threshold for Health Care Interventions in Malaysia.
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Lim, Yen Wei, Shafie, Asrul Akmal, Chua, Gin Nie, and Ahmad Hassali, Mohammed Azmi
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MEDICAL care , *COST effectiveness , *MEDICAL informatics , *COMPARATIVE studies , *ECONOMICS , *HEALTH status indicators , *INCOME , *RESEARCH methodology , *MEDICAL cooperation , *QUALITY of life , *REGRESSION analysis , *RESEARCH , *SOCIOECONOMIC factors , *EVALUATION research , *EDUCATIONAL attainment , *CROSS-sectional method , *QUALITY-adjusted life years - Abstract
Background: One major challenge in prioritizing health care using cost-effectiveness (CE) information is when alternatives are more expensive but more effective than existing technology. In such a situation, an external criterion in the form of a CE threshold that reflects the willingness to pay (WTP) per quality-adjusted life-year is necessary.Objectives: To determine a CE threshold for health care interventions in Malaysia.Methods: A cross-sectional, contingent valuation study was conducted using a stratified multistage cluster random sampling technique in four states in Malaysia. One thousand thirteen respondents were interviewed in person for their socioeconomic background, quality of life, and WTP for a hypothetical scenario.Results: The CE thresholds established using the nonparametric Turnbull method ranged from MYR12,810 to MYR22,840 (~US $4,000-US $7,000), whereas those estimated with the parametric interval regression model were between MYR19,929 and MYR28,470 (~US $6,200-US $8,900). Key factors that affected the CE thresholds were education level, estimated monthly household income, and the description of health state scenarios.Conclusions: These findings suggest that there is no single WTP value for a quality-adjusted life-year. The CE threshold estimated for Malaysia was found to be lower than the threshold value recommended by the World Health Organization. [ABSTRACT FROM AUTHOR]- Published
- 2017
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