ArticleMedicine2026
Monetary evaluation of quality-adjusted life year in patients with malignant tumor in China: Willingness-to-pay analysis.
Article in Medicine, 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
backgroundThe objective of our study was to investigate the willingness to pay (WTP) per quality-adjusted life year (QALY) among people with malignancies in China, and the associated factors that significantly affect WTP/QALY ratios.
methodsWe conducted a cross-sectional survey using the contingent valuation method and employed the EuroQol-5 Dimensions (EQ-5D), European Organisation for Research and Treatment of Cancer Quality of Life Utility Measure-Core 10 Dimensions (QLU-C10D), and WTP questionnaires to extract information on demographic characteristics, health utility, and WTP for full recovery from the respondents. Furthermore, we conducted stepwise regression analyses to identify factors affecting the WTP/QALY ratios.
resultsWe received 1012 valid questionnaires, comprising 588 patients and 424 family members. The mean age of the patients was 57.05 (11.48) years. There were 483 male patients and 529 female patients; the numbers of urban and rural patients were 576 and 436, respectively. The mean scores of health utility (standard deviation) measured by EuroQol Five-Dimensional Five-Level Questionnaire and QLU-C10D were 0.75 (0.20) and 0.74 (0.16). For the overall sample, the mean and median WTP/QALY values based on the EQ-5D instrument were 336,236 renminbi (RMB) (4.67 times gross domestic product [GDP] per capita) and 177,814 RMB (2.47 times GDP per capita), and 344,233 RMB (4.78 times GDP per capita) and 152,386 RMB (2.12 times GDP per capita) for the QLU-C10D instrument. There was no significant difference between the WTP/QALY values based on different cancers. In stepwise regression models, the WTP/QALY value was significantly correlated with health utility, income level, employment status, regular physical examination, etc.
conclusionThis paper evaluated the monetary value of QALY among people with malignancies in China. Our analysis reveals an inverse relationship between national income levels and the ratio of WTP per QALY to GDP per capita, suggesting that lower-income countries may adopt relatively higher cost-utility thresholds in proportion to their GDP per capita. Additionally, the ratios of WTP/QALY to GDP per capita for patients with malignant tumors are similar to those of the general population with life-threatening conditions; patients with non-life-threatening diseases have comparable WTP/QALY to GDP per capita ratios with the general population in a quality-of-life improvement scenario, providing empirical reference for decision-making and resource allocation in the stratified disease management. Future studies with more representative samples across a broader range of countries are warranted to enable a more comprehensive and systematic discussion.
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