An Estimation of Cost-Effectiveness Threshold: Calculating the Monetary Value of a Quality-Adjusted Life Year

Background. The cost-effectiveness threshold represents the maximum monetary amount per health outcome considered acceptable for adopting a new intervention or technology. It serves as a straightforward decision-making tool to determine cost-effective interventions. Different jurisdictions apply this tool to optimize monetary investments to provide patients with additional quality-adjusted life years (QALYs). The willingness-to-pay approach-used in this study to project the monetary worth of a QALY- is one way to derive this cost-effectiveness threshold. Methods. This cross-sectional study, conducted in 2019, was tailored to Iran’s socioeconomic context. It comprised a survey in Tabriz, a metropolitan city, with a sample size of 304 participants without any particular disorders. The study employed the contingent valuation method and the willingness-to-pay approach. The data were acquired by interviews, and a researcher-designed questionnaire. Data analysis was conducted using Excel 2010 and STATA 16 software, employing the Weibull regression model. Results. The results revealed that the median willingness to pay among Tabriz citizens in 2019 for one QALY was 715,001,033 rials. This figure is 1.05 times Iran's 2017 per capita GDP, less than the upper limit of the World Health Organization (WHO)'s recommended cost-effectiveness level. Key factors in the study were household income, level of education, and number of children. Other variables, such as gender, employment status, age, and marital status, did not significantly impact the willingness to pay. Conclusion. Based on the results of this study, the threshold obtained is lower than that proposed by the WHO. Our findings align with those of other studies and can serve as crucial input for economic evaluation studies.