心臓移植の便益 : 支払意志による評価

Objective : Since heart transplantation (HT) is expensive high medical technology, its benefitsand costs should be examined for appropriate utilization. In Japan, this issue has becomemore and more controversial. To estimate benefits of HT, economic evaluation usingwillingness to pay (WTP) carried out.Subjects and methods : Subjects were 85 medical students in Japan. An interview surveywas carried out to estimate the value of HT. Contingent valuation using WTP was done tovalue HT in monetary terms. As WTP, direct method (open-ended questions) and biddinggames were used. Household income among the subjects and improvement of quality of lifeby HT were assessed. As scope tests, correlation between them and WTP was examined.The valid response (rate) was 85 (100). The average age (standard deviation) was 22.4 (2.5).The proportion of men was 59%.Results : The average (standard deviation) WTP for HT by direct and bidding game methodswere $45,200 (38900) and $46,700 (44400), respectively. They were higher than costs of HTreported in the published papers. There was no statistical significance in correlation betweenWTP and income. However, statistically significant correlation was observed between WTPand improvement of quality of life by HT.Conclusion : This study shows that WTP is applicable to evaluate benefits of HT in monetaryterms. WTP was higher than costs of HT reported. These results indicate that HT iscost-benefit. Based on this study, further research among patients with heart diseases andthe general population should be done for healthcare policy decision.