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QALYs without bias? Nonparametric correction of time trade‐off and standard gamble weights based on prospect theory

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  • Stefan A. Lipman
  • Werner B.F. Brouwer
  • Arthur E. Attema

Abstract

Common health state valuation methodologies, such as standard gamble (SG) and time trade‐off (TTO), typically produce different weights for identical health states. We attempt to alleviate these differences by correcting the confounding influences modeled in prospect theory: loss aversion and probability weighting. Furthermore, we correct for nonlinear utility of life duration. In contrast to earlier attempts at correcting TTO and SG weights, we measure and correct all these tenets simultaneously, using newly developed nonparametric methodology. These corrections were applied to three less‐than‐perfect health states, measured with TTO and SG. We found considerable loss aversion and probability weighting for both gains and losses in life years, and we observe concave utility for gains and convex utility for losses in life years. After correction, the initially significant differences in weights between TTO and SG disappeared for all health states. Our findings suggest new opportunities to account for bias in health state valuations but also the need for further validation of resulting weights.

Suggested Citation

  • Stefan A. Lipman & Werner B.F. Brouwer & Arthur E. Attema, 2019. "QALYs without bias? Nonparametric correction of time trade‐off and standard gamble weights based on prospect theory," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 843-854, July.
  • Handle: RePEc:wly:hlthec:v:28:y:2019:i:7:p:843-854
    DOI: 10.1002/hec.3895
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    1. Thesis Thursday: Stefan Lipman
      by Chris Sampson in The Academic Health Economists' Blog on 2021-01-21 07:00:04

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    2. Spencer, Anne & Rivero-Arias, Oliver & Wong, Ruth & Tsuchiya, Aki & Bleichrodt, Han & Edwards, Rhiannon Tudor & Norman, Richard & Lloyd, Andrew & Clarke, Philip, 2022. "The QALY at 50: One story many voices," Social Science & Medicine, Elsevier, vol. 296(C).
    3. Johanna Vásquez & Sergio Botero, 2020. "Hybrid Methodology to Improve Health Status Utility Values Derivation Using EQ-5D-5L and Advanced Multi-Criteria Techniques," IJERPH, MDPI, vol. 17(4), pages 1-18, February.
    4. Lipman, Stefan A. & Brouwer, Werner B.F. & Attema, Arthur E., 2020. "Living up to expectations: Experimental tests of subjective life expectancy as reference point in time trade-off and standard gamble," Journal of Health Economics, Elsevier, vol. 71(C).

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