IDEAS home Printed from https://ideas.repec.org/p/cty/dpaper/08-02.html
   My bibliography  Save this paper

A note on the nature of utility in time and health and implications for cost utility analysis

Author

Listed:
  • Buckingham, K.
  • Devlin, N.

Abstract

Time Trade-Off valuations of health are widely used in economic evaluation of health care. Current approaches to eliciting TTO values, and their use in economic evaluation, rests on specific assumptions about the way utility relates to time and health. Both the assumptions themselves and evidence of violations of them are discussed in the literature - yet the issues appear not to be widely appreciated by those using and applying TTO. This paper adds to that literature by demonstrating both the requirements of TTO and violations of these assumptions in terms of the underlying indifference curve maps and utility functions. The advantage of this approach is that is demonstrates very clearly a number of fundamental problems for the way TTO values are currently elicited and used in Cost Utility Analysis. In essence, it is extremely unwise to assume that the current "tariffs" of TTO values, such as those routinely used by NICE and other organisations, can be applied irrespective of the duration of the health states to which they are assigned. The estimates of QALYs that result will, quite often, simply be wrong. We suggest a number of solutions, including the provision of multiple value sets, for a range of durations.

Suggested Citation

  • Buckingham, K. & Devlin, N., 2008. "A note on the nature of utility in time and health and implications for cost utility analysis," Working Papers 08/02, Department of Economics, City University London.
    • Handle: RePEc:cty:dpaper:08/02
    as

    Download full text from publisher

    File URL: https://openaccess.city.ac.uk/id/eprint/1480/1/0802_buckingham-devlin.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Aki Tsuchiya & Paul Dolan, 2005. "The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature," Medical Decision Making, , vol. 25(4), pages 460-467, July.
    3. Donald L. Patrick & Helene E. Starks & Kevin C. Cain & Richard F. Uhlmann & Robert A. Pearlman, 1994. "Measuring Preferences for Health States Worse than Death," Medical Decision Making, , vol. 14(1), pages 9-18, February.
    4. Angela Robinson & Anne Spencer, 2006. "Exploring challenges to TTO utilities: valuing states worse than dead," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 393-402, April.
    5. Ken Buckingham & Nancy Devlin, 2006. "A theoretical framework for TTO valuations of health," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1149-1154, October.
    6. Dolan, Paul & Stalmeier, Peep, 2003. "The validity of time trade-off values in calculating QALYs: constant proportional time trade-off versus the proportional heuristic," Journal of Health Economics, Elsevier, vol. 22(3), pages 445-458, May.
    Full references (including those not matched with items on IDEAS)

    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. Buckingham, Ken J. & Devlin, Nancy Joy, 2009. "A note on the nature of utility in time and health and implications for cost utility analysis," Social Science & Medicine, Elsevier, vol. 68(2), pages 362-367, January.
    2. Sharma, Rajiv & Stano, Miron, 2010. "Implications of an economic model of health states worse than dead," Journal of Health Economics, Elsevier, vol. 29(4), pages 536-540, July.
    3. Liv Ariane Augestad & Kim Rand-Hendriksen & Ivar Sønbø Kristiansen & Knut Stavem, 2012. "Impact of Transformation of Negative Values and Regression Models on Differences Between the UK and US EQ-5D Time Trade-Off Value Sets," PharmacoEconomics, Springer, vol. 30(12), pages 1203-1214, December.
    4. Arthur Attema & Yvette Edelaar-Peeters & Matthijs Versteegh & Elly Stolk, 2013. "Time trade-off: one methodology, different methods," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 53-64, July.
    5. 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.
    6. Nicolas A. Menzies & Joshua A. Salomon, 2011. "Non‐monotonicity in the episodic random utility model," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1523-1531, December.
    7. Arthur E. Attema & Matthijs M. Versteegh & Mark Oppe & Werner B. F. Brouwer & Elly A. Stolk, 2013. "Lead Time Tto: Leading To Better Health State Valuations?," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 376-392, April.
    8. Nancy J. Devlin & Aki Tsuchiya & Ken Buckingham & Carl Tilling, 2011. "A uniform time trade off method for states better and worse than dead: feasibility study of the ‘lead time’ approach," Health Economics, John Wiley & Sons, Ltd., vol. 20(3), pages 348-361, March.
    9. Devlin, N. & Tsuchiya, A. & Buckingham, K. & Tilling, C., 2009. "A uniform Time Trade Off method for states better and worse than dead: feasibility study of the ‘lead time’ approach," Working Papers 09/08, Department of Economics, City University London.
    10. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    11. McTaggart-Cowan, Helen & Tsuchiya, Aki & O'Cathain, Alicia & Brazier, John, 2011. "Understanding the effect of disease adaptation information on general population values for hypothetical health states," Social Science & Medicine, Elsevier, vol. 72(11), pages 1904-1912, June.
    12. Samer A. Kharroubi & Yara Beyh, 2021. "Bayesian modeling of health state preferences: could borrowing strength from existing countries’ valuations produce better estimates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 773-788, July.
    13. Luciana Scalone & Peep Stalmeier & Silvano Milani & Paul Krabbe, 2015. "Values for health states with different life durations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(9), pages 917-925, December.
    14. Craig, Benjamin M. & Oppe, Mark, 2010. "From a different angle: A novel approach to health valuation," Social Science & Medicine, Elsevier, vol. 70(2), pages 169-174, January.
    15. Craig., Benjamin M. & Busschbach, Jan J.V., 2011. "Revisiting United States valuation of EQ-5D states," Journal of Health Economics, Elsevier, vol. 30(5), pages 1057-1063.
    16. L. M. Lamers & J. McDonnell & P. F. M. Stalmeier & P. F. M. Krabbe & J. J. V. Busschbach, 2006. "The Dutch tariff: results and arguments for an effective design for national EQ‐5D valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1121-1132, October.
    17. Peep F. M. Stalmeier & Jan J. V. Busschbach & Leida M. Lamers & Paul F. M. Krabbe, 2005. "The gap effect: discontinuities of preferences around dead," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 679-685, July.
    18. R. Hoorn & A. Donders & M. Oppe & P. Stalmeier, 2014. "The Better than Dead Method: Feasibility and Interpretation of a Valuation Study," PharmacoEconomics, Springer, vol. 32(8), pages 789-799, August.
    19. John Brazier & Donna Rowen & Yaling Yang & Aki Tsuchiya, 2012. "Comparison of health state utility values derived using time trade-off, rank and discrete choice data anchored on the full health-dead scale," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 575-587, October.
    20. Liv Augestad & Kim Rand-Hendriksen & Ivar Kristiansen & Knut Stavem, 2012. "Impact of Transformation of Negative Values and Regression Models on Differences Between the UK and US EQ-5D Time Trade-Off Value Sets," PharmacoEconomics, Springer, vol. 30(12), pages 1203-1214, December.

    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:cty:dpaper:08/02. 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: Research Publications Librarian (email available below). General contact details of provider: https://edirc.repec.org/data/decituk.html .

    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.