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Do individuals consider expected income when valuing health states?

Published online by Cambridge University Press:  01 October 2008

Thomas Davidson  and
Lars-Åke Levin
Thomas Davidson
Affiliation:
Linköping University
Lars-Åke Levin
Affiliation:
Linköping University
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Abstract

Objectives: The purpose of this study was to empirically explore whether individuals take their expected income into consideration when directly valuing predefined health states. This was intended to help determine how to handle productivity costs due to morbidity in a cost-effectiveness analysis.

Methods: Two hundred students each valued four hypothetical health states by using time trade-off (TTO) and a visual analogue scale (VAS). The students were randomly assigned to two groups. One group was simply asked, without mentioning income, to value the different health states (the non-income group). The other group was explicitly asked to consider their expected income in relation to the health states in their valuations (the income group).

Results: For health states that are usually assumed to have a large effect on income, the valuations made by the income group seemed to be lower than the valuations made by the non-income group. Among the students in the non-income group, 96 percent stated that they had not thought about their expected income when they valued the health states. In the income group, 40 percent believed that their expected income had affected their valuations of the health states.

Conclusion: The results show that, as long as income is not mentioned, most individuals do not seem to consider their expected income when they value health states. This indicates that productivity costs due to morbidity are not captured within individuals' health state valuations. These findings, therefore, suggest that productivity costs due to morbidity should be included as a cost in cost-effectiveness analyses.

Keywords

Cost-effectiveness analysisValuationHealth state utilityExpected income
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 24 , Issue 4 , October 2008 , pp. 488 - 494
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

1. Björk, S, Norinder, A. The weighting exercise for the Swedish version of the EuroQoL. Health Econ. 1999;8:117–126.Google Scholar
2. Bleichrodt, H, Johannesson, MD. The validity of QALYs: An experimental test of constant proportional tradeoff and utility independence. Med Decis Making. 1996;17:21–32.Google Scholar
3. Brouwer, WB, Koopmanschap, MA, Rutten, FF. Productivity costs measurement through quality of life? A response to the recommendation of the Washington Panel. Health Econ. 1997;6:253–259.Google Scholar
4. Brouwer, WB, Meerding, WJ, Lamers, LM, Severens, JL. The relationship between productivity and health-related QOL: An exploration. Pharmacoeconomics. 2005;23:209–218.Google Scholar
5. Brouwer, WB, Rutten, F.F. The missing link: On the line between C and E. Health Econ. 2003;12:629–636.Google Scholar
6. Dolan, P. Modeling valuations for EuroQol Health states. Med Care. 1997;35:1095–1098.CrossRefGoogle ScholarPubMed
7. Dolan, P, Gudex, C, Kind, P, Williams, A. The time trade-off method: Results from a general population study. Health Econ. 1996;5:141–154.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
8. Gold, MR, Siegel, JE, Russel, LB, Weinstein, MC. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.Google Scholar
9. Krol, M, Brouwer, WB, Sendi, P. Productivity costs in health-state valuations: Does explicit instruction matter? Pharmacoeconomics. 2006;24:401–414.Google Scholar
10. Marra, CA, Lynd, LD, Esdaile, JM, Kopec, J, Anis, AH. The impact of low family income on self-reported health outcomes in patients with rheumatoid arthritis within a publicly funded health-care environment. Rheumatology. 2004;43:1390–97.Google Scholar
11. Meltzer, D, Johannesson, M. Inconsistencies in the “societal perspective” on costs of the Panel on Cost-Effectiveness in Health and Medicine. Med Decis Making. 1999;19:371–377.Google Scholar
12. Meltzer, D, Weckerle, CE, Chang, LM. Do people consider financial effects in answering quality of life questions? Med Decis Making. 1999;19:517.Google Scholar
13. Myers, J, McCabe, S, Gohmann, S. Quality-of-life assessment when there is a loss of income. Med Decis Making. 2007;27:27–33.Google Scholar
14. Parkin, D, Devlin, N. Is there a case for using visual analogue scale valuations in cost-utility analysis? Health Econ. 2006;15:653–664.Google Scholar
15. Rabin, R, de Charro, F. EQ-5D: A measure of health status from the EuroQol group. Ann Med. 2001;33:337–343.CrossRefGoogle ScholarPubMed
16. Richardson, JR, Olsen, JA. In defence of societal sovereignty: A comment on Nyman ‘the inclusion of survivor consumption in CUA’. Health Econ. 2006;15:311–313; discussion 319–322.Google Scholar
17. Sculpher, MJ, O'Brien, B. Income effects of reduced health and health effects of reduced income: Implications for health-state valuation. Med Decis Making. 2000;20:207–215.Google Scholar
18. Sendi, P, Brouwer, WB. Is silence golden? A test of the incorporation of the effects of ill-health on income and leisure in health state valuations. Health Econ. 2005;14:643–647.Google Scholar
19. Weinstein, MC, Siegel, JE, Garber, AM et al., Productivity costs, time costs and health-related quality of life: A response to the Erasmus group. Health Econ. 1997;6:505–510.3.0.CO;2-I>CrossRefGoogle Scholar
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