Luciana Scalone1, Peep F M Stalmeier2, Silvano Milani3, Paul F M Krabbe4. 1. Department of Clinical Medicine and Prevention, Faculty of Medicine, Research Centre on Public Health, University of Milano-Bicocca, Villa Serena, Via Pergolesi 33, 20052, Monza, Italy. luciana.scalone@unimib.it. 2. Department for Health Evidence, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. 3. Department of Occupational Medicine, Institute of Medical Statistics and Biometrics "GA Maccacaro", Faculty of Medicine, University of Milano, Cascina Rosa, Via Vanzetti 5, 20133, Milano, Italy. 4. Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
Abstract
BACKGROUND: Recent research suggests that the value of health states may depend on their duration, implying a more complex relationship between quality and quantity of life than the standard linear relationship assumed in the quality-adjusted life years (QALY) model. OBJECTIVE: This study models how duration affects the value of health states, using discrete choice data. METHODS: A study was conducted comprising health profiles including various durations. Health states were described with the EQ-5D. Duration was introduced as a sixth domain with six levels (1, 5, 10, 15, 30, 50 years). Sixty pairs of health profiles were selected, applying a Bayesian approach. Two hundred eight university students self-completed the computerized response tasks. Data were analyzed with a conditional logistic regression model. RESULTS: There is clear evidence for non-linear values for duration, that is, preferences for duration are more accurately described by a logarithmic function. CONCLUSIONS: In discrete choice experiments using health states with different durations, these data present the first evidence for decreasing marginal utility for duration. Our results suggest that refinement of the standard QALY framework may be needed for states with a long duration.
BACKGROUND: Recent research suggests that the value of health states may depend on their duration, implying a more complex relationship between quality and quantity of life than the standard linear relationship assumed in the quality-adjusted life years (QALY) model. OBJECTIVE: This study models how duration affects the value of health states, using discrete choice data. METHODS: A study was conducted comprising health profiles including various durations. Health states were described with the EQ-5D. Duration was introduced as a sixth domain with six levels (1, 5, 10, 15, 30, 50 years). Sixty pairs of health profiles were selected, applying a Bayesian approach. Two hundred eight university students self-completed the computerized response tasks. Data were analyzed with a conditional logistic regression model. RESULTS: There is clear evidence for non-linear values for duration, that is, preferences for duration are more accurately described by a logarithmic function. CONCLUSIONS: In discrete choice experiments using health states with different durations, these data present the first evidence for decreasing marginal utility for duration. Our results suggest that refinement of the standard QALY framework may be needed for states with a long duration.
Keywords:
Discrete choice analysis; Duration; Health states; Quality-adjusted life years; Time preferences; Values
Authors: Christopher McCabe; John Brazier; Peter Gilks; Aki Tsuchiya; Jennifer Roberts; Anthony O'Hagan; Katherine Stevens Journal: J Health Econ Date: 2006-02-24 Impact factor: 3.883
Authors: Catharina G M Groothuis-Oudshoorn; Edwin R van den Heuvel; Paul F M Krabbe Journal: BMC Med Res Methodol Date: 2018-06-22 Impact factor: 4.615