ArticlePublic health in practice (Oxford, England)2026
Assessment of cost-effectiveness threshold using a double-bounded dichotomous choice model.
Article in Public health in practice (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Willingness to pay (WTP) for one quality-adjusted life year (QALY) is highly variable according to survey methodology and can change over time, even within the same population. Our study objective was to assess Japanese WTP per QALY gain using a double-bounded dichotomous choice method for a scenario in the post-COVID-19 pandemic period. Study design: A cross-sectional survey. Methods: We conducted an online survey in 2024 to determine the mean WTP using double-bounded dichotomous choice among 2,500 Japanese adults. Four scenarios were presented (three for a non-fatal disease from three different perspectives and one scenario from an individual perspective) in two series of questions regarding WTP with the disease. Results: The mean WTP per QALY gain with moderate and severe health status was 3.30 (95 % confidence interval: 2.38-4.36) and 3.36 (2.62-4.36) for a non-fatal disease and individual perspective, 7.34 (5.61-9.33) and 4.43 (3.45-5.57) million Japanese Yen (JPY) in 2025 for a non-fatal disease from societal and individual perspectives, 8.44 (6.49-10.56) and 5.58 (4.49-6.87) million JPY for a non-fatal disease from a societal but excluding an individual perspective, respectively; 8.41 (5.78-9.66) million JPY for a fatal disease with 6 months' treatment, 9.95 (7.45-12.71) million JPY for fatal disease with 6 months' prevention, 3.38 (2.78-5.42) million JPY for a fatal disease with 18 months' treatment, and 4.18 (3.29-6.65) million JPY for a fatal disease with 18 months' prevention, respectively. Conclusions: No significant change was observed in WTP between after versus before the COVID-19 pandemic. However, our findings suggest that questionnaire design may greatly influence response patterns. Further detailed examination is required to understand how these values have changed following the COVID-19 pandemic.
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