OBJECTIVES: Recently, a non-preference-based method, the subjective well-being approach has been gaining popularity to value non-market goods such as a quality-adjusted life year (QALYs). The approach uses econometric regression analysis to estimate the shadow price of non-market goods. The main goal of this paper is to determine the monetary value of one QALY using four different well-being measures in Hungary.

METHODS: In 2019, a cross-sectional, representative, computer-assisted personal interview survey was performed among the adult general population of Hungary. The EQ-5D-5L instrument was used to assess the participants’ health utilities. Using four different well-being measures- The World Health Organisation- Five Well-Being Index (WHO-5), happiness scale (0-10), life-satisfaction scale (0-10) and Satisfaction with Life Scale (SWLS) – four separate regression models were estimated (Models 1-4). The independent variables that were selected to be regressed on the four well-being measures were: family status, type of residence, employment, EQ-5D-5L index score and income. Regression coefficients were then used to obtain shadow prices (in Euro 2019) for one QALY by estimating the marginal rates of substitution between income and EQ-5D index scores.

RESULTS: A total of 2,023 participants took part in the survey. Of them, 50% were female and the average age was 48.72 (SD=1.66) years. All standardized regression coefficients for EQ-5D index in Models 1-4 were positive (0.516, 0.441, 0.418 and 0.284) and significant (p<0.001). The shadow price for a QALY were € 86,025, € 72,399, € 70,731 and € 47,783 per annum using the WHO-5, happiness, SWLS and life-satisfaction scales, respectively.

CONCLUSIONS: We observed substantial differences between shadow price for a QALY across different well-being measures. All shadow price estimates were higher than the financing threshold (42,250 EUR/QALY) used by the National Health Insurance Fund Administration of Hungary for reimbursement decisions.