Monetary Valuation of a Quality-Adjusted Life Year (QALY) for Depressive Disorders Among Patients and Non-Patient Respondents: A Matched Willingness to Pay Study.

Background: As estimated by the World Health Organization, depressive disorders will be the leading contributor to the Global Burden of Disease by 2030. In light of this fact, we designed a study whose aim was to investigate whether the value placed on health-related quality of life (HRQoL) for a depressive disorder is higher in patients diagnosed with a major depressive disorder (MDD) compared to non-patients in a matched sample.

Method: We collected data on willingness to pay (WTP) for a total of four health-gain scenarios, which were presented to 18 outpatients diagnosed with a MDD versus 18 matched non-patient respondents with no symptoms of depression. Matching characteristics included age, income, level of education, and type of health insurance. Respondents were presented with different HRQoL scenarios in which they could choose to pay money to regain their initial health state through various treatment options (e.g., inpatient treatment, electroconvulsive therapy). To test whether the probability of stating a positive WTP differed significantly between the two samples, Fisher's exact test was used. Differences regarding stated WTP between the samples were investigated using the Mann-Whitney U-test.

Results: For most of the health scenarios, the probability of stating a positive WTP did not differ between the two samples. However, patient respondents declared WTP values up to 7.4 times higher than those stated by matched non-patient respondents.

Conclusion: Although the perceived necessity to pay for mental-HRQoL gains did not differ between respondents with MDD and respondents with no symptoms of depression, patient respondents stated higher values.