From Health to Wellbeing: Towards a Monetary Valuation of a Wellbeing-Adjusted Life Year

Objectives Economic evaluations using broader measures to capture benefits beyond improved health can inform policy-making, but only if the monetary value of gains measured using these instruments is understood. This study explored contingent valuation as a method to estimate the monetary value of a wellbeing-adjusted life year (WALY) as measured by ICECAP-A. Methods In a large online survey of representative samples from seven European countries, participants valued a change in the ICECAP-A from their current health state to a randomly assigned hypothetical state. Participants were instructed that an unspecified treatment could avoid a loss or produce a gain in wellbeing, and were asked for their willingness to pay (WTP) for this treatment. WTP per WALY was calculated using an aggregated approach that employed ICECAP-A tariffs from the United Kingdom. Results We analyzed a sample of 7428 observations, focusing on avoided losses (n=6002) because the results for gains were not theoretically valid. Different cut-off points for a marginal change were explored. Depending on the definition of a marginal change, WTP per WALY averaged between €13323.28 and €61375.63 for avoided losses between [0,0.1] and [0,0.5], respectively, for one month. Mean WTP per WALY varied across the countries as follows: Denmark (€17867.93 - €88634.14), France (€10278.35 - €45581.28), Germany (€12119.39 - €54566.56), Italy (€11753.69 - €52161.25), Netherlands (€ 14612.88 - €58951.74), Spain (€11904.12 - €57909.17), and United Kingdom (€13133.75 - €68455.85). Conclusion Despite the inherent limitations of our study, it offers valuable insights into methods for eliciting the WTP for changes in capability wellbeing as measured with ICECAP-A.