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A comparison of patient and population values for health states in varicose veins patients

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  • Julie Ratcliffe
  • John Brazier
  • Simon Palfreyman
  • Jonathan Michaels

Abstract

Cost utility analyses typically incorporate preferences based upon the mean values for health states generated from a sample of the general population. The main argument for using general population values rests upon the premise that in a publicly funded health care system the main objective of the health care system is a societal one, namely to maximise health subject to equity concerns. Alternatively, it can be argued that patients themselves should be asked to value their own health state given that they have first hand experience of the state being valued. This paper investigates the relationship between patient and general population values within the context of a randomised controlled trial to compare alternative treatments for varicose veins. It was found that patients' own health valuations tended to be higher than those of the general population sample. The results from this study have important implications for economic evaluation. The incremental QALY gain for patients receiving treatment for moderate varicose veins would be almost halved if patients' own values were used to estimate QALYs in contrast to the general population values. The results also suggest that the variant of elicitation technique may be more important than the source of those values in revealing discrepancies. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • Julie Ratcliffe & John Brazier & Simon Palfreyman & Jonathan Michaels, 2007. "A comparison of patient and population values for health states in varicose veins patients," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 395-405, April.
    • Handle: RePEc:wly:hlthec:v:16:y:2007:i:4:p:395-405
    DOI: 10.1002/hec.1170
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    Cited by:

    1. P. Wang & E. Tai & J. Thumboo & Hubertus Vrijhoef & Nan Luo, 2014. "Does Diabetes Have an Impact on Health-State Utility? A Study of Asians in Singapore," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(3), pages 329-337, September.
    2. Brandt, Sylvia J. & Lavin, Felipe Vasquez & Hanemann, W. Michael, 2008. "Designing contingent valuation scenarios for environmental health: The case of childhood asthma," CUDARE Working Papers 47077, University of California, Berkeley, Department of Agricultural and Resource Economics.
    3. David G. T. Whitehurst & Stirling Bryan & Martyn Lewis, 2011. "Systematic Review and Empirical Comparison of Contemporaneous EQ-5D and SF-6D Group Mean Scores," Medical Decision Making, , vol. 31(6), pages 34-44, November.
    4. John Brazier & Donna Rowen & Milad Karimi & Tessa Peasgood & Aki Tsuchiya & Julie Ratcliffe, 2018. "Experience-based utility and own health state valuation for a health state classification system: why and how to do it," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 881-891, July.
    5. Elliott, Jack & Tsuchiya, Aki, 2022. "Do they just know more, or do they also have different preferences? An exploratory analysis of the effects of self-reporting serious health problems on health state valuation," Social Science & Medicine, Elsevier, vol. 315(C).

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