IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v19y2010i6p644-655.html
   My bibliography  Save this article

Analysing risk attitudes to time

Author

Listed:
  • Adam Oliver
  • Richard Cookson

Abstract

The assumption of risk neutrality over discounted life years underlies the standard QALY model of individual preferences over health outcomes, and is thus implicitly assumed by NICE and other health technology advisory bodies worldwide. The primary objective of this article is to report a study to test the assumption in a convenience sample of 30 respondents with use of the probability equivalence version of the standard gamble. The results indicate considerable risk aversion over life years, and therefore call into question the standard assumption of risk neutrality in practical cost‐utility analyses (CUA). A secondary objective is to observe whether risk aversion can be reduced through the use of the lottery equivalents method, under the hypothesis that the gambling effect can be lessened with this instrument. In a separate convenience sample of 40 respondents, however, the observed level of risk aversion was at least that seen in the standard gamble. Further research is warranted to ascertain whether risk aversion over discounted life years is a generalisable concern. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Adam Oliver & Richard Cookson, 2010. "Analysing risk attitudes to time," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 644-655, June.
    • Handle: RePEc:wly:hlthec:v:19:y:2010:i:6:p:644-655
    DOI: 10.1002/hec.1499
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1499
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1499?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. Dolan, Paul & Cookson, Richard, 2000. "A qualitative study of the extent to which health gain matters when choosing between groups of patients," Health Policy, Elsevier, vol. 51(1), pages 19-30, February.
    2. Amiram Gafni & George W. Torrance, 1984. "Risk Attitude and Time Preference in Health," Management Science, INFORMS, vol. 30(4), pages 440-451, April.
    3. Lia C.G. Verhoef & Anton F.J. De Haan & Willem A.J. Van Daal, 1994. "Risk Attitude in Gambles with Years of Life," Medical Decision Making, , vol. 14(2), pages 194-200, April.
    4. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-114, November.
    5. John C. Hershey & Paul J. H. Schoemaker, 1985. "Probability Versus Certainty Equivalence Methods in Utility Measurement: Are they Equivalent?," Management Science, INFORMS, vol. 31(10), pages 1213-1231, October.
    6. A.M. Stiggelbout & G.M. Kiebert & J. Kievit & J.W.H. Leer & G. Stoter & J.C.J.M. De Haes, 1994. "Utility Assessment in Cancer Patients," Medical Decision Making, , vol. 14(1), pages 82-90, February.
    7. Eric J. Johnson & David A. Schkade, 1989. "Bias in Utility Assessments: Further Evidence and Explanations," Management Science, INFORMS, vol. 35(4), pages 406-424, April.
    8. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    9. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    10. Oliver, Adam, 2003. "A quantitative and qualitative test of the Allais paradox using health outcomes," LSE Research Online Documents on Economics 155, London School of Economics and Political Science, LSE Library.
    11. Friedrich Breyer & Victor R. Fuchs, 1982. "Risk Attitudes in Health: An Exploratory Study," NBER Working Papers 0875, National Bureau of Economic Research, Inc.
    12. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    13. Stephen A. Eraker & Harold C. Sox, 1981. "Assessment of Patients' Preferences for Therapeutic Outcomes," Medical Decision Making, , vol. 1(1), pages 29-39, February.
    14. Oliver, Adam, 2003. "A quantitative and qualitative test of the Allais paradox using health outcomes," Journal of Economic Psychology, Elsevier, vol. 24(1), pages 35-48, February.
    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. Joseph G Eisenhauer, 2012. "Measuring Aversion to Health Risks," Journal of Economics and Behavioral Studies, AMH International, vol. 4(2), pages 96-107.
    2. Schosser, Stephan & Trarbach, Judith N. & Vogt, Bodo, 2016. "How does the perception of pain determine the selection between different treatments?," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 174-182.

    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. Oliver, Adam, 2003. "The internal consistency of the standard gamble: tests after adjusting for prospect theory," LSE Research Online Documents on Economics 159, London School of Economics and Political Science, LSE Library.
    2. van der Pol, Marjon & Ruggeri, Matteo, 2008. "Is risk attitude outcome specific within the health domain?," Journal of Health Economics, Elsevier, vol. 27(3), pages 706-717, May.
    3. Stefan A. Lipman & Arthur E. Attema, 2019. "Rabin's paradox for health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 1064-1071, August.
    4. Oliver, Adam, 2003. "The internal consistency of the standard gamble: tests after adjusting for prospect theory," Journal of Health Economics, Elsevier, vol. 22(4), pages 659-674, July.
    5. José‐María Abellán‐Perpiñán & José‐Luis Pinto‐Prades & Ildefonso Méndez‐Martínez & Xabier Badía‐Llach, 2006. "Towards a better QALY model," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 665-676, July.
    6. 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).
    7. James K. Hammitt, 2002. "QALYs Versus WTP," Risk Analysis, John Wiley & Sons, vol. 22(5), pages 985-1001, October.
    8. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier, 2013. "Prospect theory in the health domain: A quantitative assessment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1057-1065.
    9. James K. Hammitt, 2017. "Valuing Non-Fatal Health Risks: Monetary and Health-Utility Measures," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 335-356.
    10. Charles M. Harvey & Lars Peter Østerdal, 2010. "Cardinal Scales for Health Evaluation," Decision Analysis, INFORMS, vol. 7(3), pages 256-281, September.
    11. Bleichrodt, Han & Quiggin, John, 2013. "Capabilities as menus: A non-welfarist basis for QALY evaluation," Journal of Health Economics, Elsevier, vol. 32(1), pages 128-137.
    12. Juan D. Moreno-Ternero & Lars Peter Østerdal, 2017. "A normative foundation for equity-sensitive health evaluation: The role of relative comparisons of health gains," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 19(5), pages 1009-1025, October.
    13. Kristian Schultz Hansen & Lars Peter Østerdal, 2006. "Models of Quality‐Adjusted Life Years when Health Varies Over Time: Survey and Analysis," Journal of Economic Surveys, Wiley Blackwell, vol. 20(2), pages 229-255, April.
    14. Doctor, Jason N. & Bleichrodt, Han & Miyamoto, John & Temkin, Nancy R. & Dikmen, Sureyya, 2004. "A new and more robust test of QALYs," Journal of Health Economics, Elsevier, vol. 23(2), pages 353-367, March.
    15. Paul F M Krabbe, 2013. "A Generalized Measurement Model to Quantify Health: The Multi-Attribute Preference Response Model," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-12, November.
    16. Arthur E. Attema & Han Bleichrodt & Yu Gao & Zhenxing Huang & Peter P. Wakker, 2016. "Measuring Discounting without Measuring Utility," American Economic Review, American Economic Association, vol. 106(6), pages 1476-1494, June.
    17. Han Bleichrodt & Jose Maria Abellan-Perpiñan & Jose Luis Pinto-Prades & Ildefonso Mendez-Martinez, 2007. "Resolving Inconsistencies in Utility Measurement Under Risk: Tests of Generalizations of Expected Utility," Management Science, INFORMS, vol. 53(3), pages 469-482, March.
    18. Han Bleichrodt & Jose Luis Pinto, 2012. "Conceptual Foundations for Health Utility Measurement," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 35, Edward Elgar Publishing.
    19. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.
    20. Marjon Pol & Larissa Roux, 2005. "Time preference bias in time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 107-111, June.

    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:19:y:2010:i:6:p:644-655. 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.