Willingness to Pay in Japan After the COVID-19 Pandemic

OBJECTIVES: In Japan, JPY 5 million/quality-adjusted life year (QALY) has often been used as a threshold value for willingness to pay (WTP). However, this figure is based on past findings and may have changed as a result of social changes caused by the COVID-19 pandemic. This study examines the value of WTP after the COVID-19 pandemic in Japan.

METHODS: We conducted an online questionnaire survey of 2,000 people between January and February 2024. Half of the participants were recruited from among registered users of a Japanese marketing research company, and half were recruited via a social networking service. Information about the socioeconomic status of the participants was obtained and all participants were asked to answer the following question: “Suppose a new, but expensive treatment is developed for a disease for which conventional treatments would result in immediate death. At present, the treatment is not covered by medical insurance and the total cost must be borne entirely by the patient. Suppose this treatment allows you to live with the condition for a year, and then you die. There is a proposed legislation that would cover the entire cost of this treatment by raising taxes. Would you support this legislation?” The cost of treatment and the health utility would vary according to the patient. The threshold value of WTP was estimated for each participant by using a probit model, with age, sex, income, education level, and the route of enrolment (research company or SNS) as explanatory variables.

RESULTS: WTP at the time of the survey was estimated as JPY 16.8 (95% confidence interval 13.0 – 20.8) million/QALY. Younger age and male sex were positively correlated with WTP.

CONCLUSIONS: Our results suggest that WTP in Japan is much higher after the COVID-19 pandemic than before. Exploring the reasons for this will be a future target of research.