IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v10y2001i4p317-324.html
   My bibliography  Save this article

Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis

Author

Listed:
  • Mark Sculpher
  • Amiram Gafni

Abstract

Public preferences are typically incorporated into cost‐effectiveness analyses (CEA) on the basis of the average health state utilities of a sample of individuals drawn from the general public. The cost‐effectiveness of a programme is then assessed on an ‘all‐or‐nothing’ basis: the programme is declared either cost‐effective or not for all patients in clinically homogenous sub‐groups. However, this approach fails to recognize variability between individuals in their preferences. In this paper, we consider how diversity in the preferences of individuals can be handled within CEA when the public's preferences are considered appropriate for defining benefit, with the objective of increasing the efficiency of health care delivery. The concept of preference sub‐group analysis is described and some of its implications are assessed. These include the methods that could be used to identify sub‐groups from amongst public raters, the appropriate approach to eliciting preferences and the possible implications of preference sub‐group analysis for clinical decision making. Copyright © 2001 John Wiley & Sons, Ltd.

Suggested Citation

  • Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    • Handle: RePEc:wly:hlthec:v:10:y:2001:i:4:p:317-324
    DOI: 10.1002/hec.592
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.592
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.592?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jack Dowie, 1998. "Towards the equitably efficient and transparently decidable use of public funds in the deep blue millennium," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 93-103, March.
    2. Loomes, Graham & McKenzie, Lynda, 1989. "The use of QALYs in health care decision making," Social Science & Medicine, Elsevier, vol. 28(4), pages 299-308, January.
    3. Claxton, Karl, 1999. "The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies," Journal of Health Economics, Elsevier, vol. 18(3), pages 341-364, June.
    4. H. Llewellyn-Thomas & H.J. Sutherland & R. Tibshirani & A. Ciampi & J.E. Till & N.F. Boyd, 1982. "The Measurement of Patients' Values in Medicine," Medical Decision Making, , vol. 2(4), pages 449-462, December.
    5. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    6. Gafni, Amiram & Charles, Cathy & Whelan, Tim, 1998. "The physician-patient encounter: The physician as a perfect agent for the patient versus the informed treatment decision-making model," Social Science & Medicine, Elsevier, vol. 47(3), pages 347-354, August.
    7. Robert F. Nease & Douglas K. Owens, 1994. "A Method for Estimating the Cost- Effectiveness of Incorporating Patient Preferences into Practice Guidelines," Medical Decision Making, , vol. 14(4), pages 382-392, October.
    8. Abraham Mehrez & Amiram Gafni, 1989. "Quality-adjusted Life Years, Utility Theory, and Healthy-years Equivalents," Medical Decision Making, , vol. 9(2), pages 142-149, June.
    9. Mark Sculpher, 1998. "The cost‐effectiveness of preference‐based treatment allocation: the case of hysterectomy versus endometrial resection in the treatment of menorrhagia," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 129-142, March.
    10. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    11. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April.
    12. Gafni, Amiram & Birch, Stephen, 1995. "Preferences for outcomes in economic evaluation: An economic approach to addressing economic problems," Social Science & Medicine, Elsevier, vol. 40(6), pages 767-776, March.
    13. Bernie O'Brien & Jose Luis Viramontes, 1994. "Willingness to Pay," Medical Decision Making, , vol. 14(3), pages 289-297, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Gregory S. Zaric, 2008. "Optimal drug pricing, limited use conditions and stratified net benefits for Markov models of disease progression," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1277-1294, November.
    2. Mathias Kifmann & Luigi Siciliani, 2017. "Average‐Cost Pricing and Dynamic Selection Incentives in the Hospital Sector," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1566-1582, December.
    3. Jennifer Roberts & Paul Dolan, 2004. "To what extent do people prefer health states with higher values? A note on evidence from the EQ‐5D valuation set," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 733-737, July.
    4. Siciliani, Luigi & Straume, Odd Rune, 2019. "Competition and equity in health care markets," Journal of Health Economics, Elsevier, vol. 64(C), pages 1-14.
    5. Angela Robinson & David Parkin, 2002. "Recognising diversity in public preferences: the use of preference sub‐groups in cost‐effectiveness analysis. A response to Sculpher and Gafni," Health Economics, John Wiley & Sons, Ltd., vol. 11(7), pages 649-651, October.
    6. Ian M. McCarthy, 2015. "Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment," Health Economics, John Wiley & Sons, Ltd., vol. 24(12), pages 1588-1603, December.
    7. Stephen Birch & Amiram Gafni, 2002. "On being NICE in the UK: guidelines for technology appraisal for the NHS in England and Wales," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 185-191, April.
    8. Gemma E. Shields & Mark Wilberforce & Paul Clarkson & Tracey Farragher & Arpana Verma & Linda M. Davies, 2022. "Factors Limiting Subgroup Analysis in Cost-Effectiveness Analysis and a Call for Transparency," PharmacoEconomics, Springer, vol. 40(2), pages 149-156, February.
    9. Nancy J. Devlin & Koonal K. Shah & Yan Feng & Brendan Mulhern & Ben van Hout, 2018. "Valuing health‐related quality of life: An EQ‐5D‐5L value set for England," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 7-22, January.
    10. Moreno, E. & Girón, F.J. & Martínez, M.L. & Vázquez-Polo, F.J. & Negrín, M.A., 2013. "Optimal treatments in cost-effectiveness analysis in the presence of covariates: Improving patient subgroup definition," European Journal of Operational Research, Elsevier, vol. 226(1), pages 173-182.
    11. Werner B.F. Brouwer & Frans F.H. Rutten, 2003. "The missing link: on the line between C and E," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 629-636, August.
    12. Clazien Bouwmans & Annemarie Kolk & Mark Oppe & Saskia Schawo & Elly Stolk & Michel Agthoven & Jan Buitelaar & LeonaHakkaart Roijen, 2014. "Validity and responsiveness of the EQ-5D and the KIDSCREEN-10 in children with ADHD," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 967-977, December.
    13. Gregory S. Zaric, 2008. "Optimal drug pricing, limited use conditions and stratified net benefits for Markov models of disease progression," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1277-1294.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mark Sculpher, 1998. "The cost‐effectiveness of preference‐based treatment allocation: the case of hysterectomy versus endometrial resection in the treatment of menorrhagia," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 129-142, March.
    2. James K. Hammitt, 2002. "QALYs Versus WTP," Risk Analysis, John Wiley & Sons, vol. 22(5), pages 985-1001, October.
    3. Charles M. Harvey & Lars Peter Østerdal, 2010. "Cardinal Scales for Health Evaluation," Decision Analysis, INFORMS, vol. 7(3), pages 256-281, September.
    4. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    5. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    6. Garry Barton & Tracey Sach & Michael Doherty & Anthony Avery & Claire Jenkinson & Kenneth Muir, 2008. "An assessment of the discriminative ability of the EQ-5D index , SF-6D, and EQ VAS, using sociodemographic factors and clinical conditions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(3), pages 237-249, August.
    7. John Brazier & Mark Deverill, 1999. "A checklist for judging preference‐based measures of health related quality of life: Learning from psychometrics," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 41-51, February.
    8. Han Bleichrodt, 2002. "A new explanation for the difference between time trade‐off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456, July.
    9. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
    10. Gafni, Amiram & Birch, Stephen, 1997. "QALYs and HYEs Spotting the differences," Journal of Health Economics, Elsevier, vol. 16(5), pages 601-608, October.
    11. Ried, Walter, 1998. "QALYs versus HYEs--what's right and what's wrong. A review of the controversy," Journal of Health Economics, Elsevier, vol. 17(5), pages 607-625, October.
    12. Kevin Haninger & James K. Hammitt, 2011. "Diminishing Willingness to Pay per Quality‐Adjusted Life Year: Valuing Acute Foodborne Illness," Risk Analysis, John Wiley & Sons, vol. 31(9), pages 1363-1380, September.
    13. Attema, Arthur E. & Brouwer, Werner B.F., 2013. "In search of a preferred preference elicitation method: A test of the internal consistency of choice and matching tasks," Journal of Economic Psychology, Elsevier, vol. 39(C), pages 126-140.
    14. Alan Shiell & Janelle Seymour & Penelope Hawe & Sue Cameron, 2000. "Are preferences over health states complete?," Health Economics, John Wiley & Sons, Ltd., vol. 9(1), pages 47-55, January.
    15. Carmen Herrero Blanco, 2001. "Individual Evidence Of Independence In Health Profiles Evaluation," Working Papers. Serie AD 2001-20, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    16. MORENO-TERNERO, Juan & OSTERDAL, Lars P., 2014. "Normative foundations for equity-sensitive population health evaluation functions," LIDAM Discussion Papers CORE 2014031, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    17. José‐Luis Pinto‐Prades & José‐María Abellán‐Perpiñán, 2005. "Measuring the health of populations: the veil of ignorance approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 69-82, January.
    18. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    19. Karen Gerard & Gavin Mooney, 1993. "Qaly league tables: Handle with care," Health Economics, John Wiley & Sons, Ltd., vol. 2(1), pages 59-64, April.
    20. Stavros Petrou & Christine Hockley, 2005. "An investigation into the empirical validity of the EQ‐5D and SF‐6D based on hypothetical preferences in a general population," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1169-1189, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:10:y:2001:i:4:p:317-324. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.