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The Lead Time Trade-Off: The Case Of Health States Better Than Death

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  • Jose Luis Pinto Prades

    ()
    (Department of Economics, Universidad Pablo de Olavide)

  • Eva Rodriguez Miguez

    ()
    (Department of Economics, Universidad de Vigo)

Abstract

The Lead Time Trade-Off (L-TTO) is a variant of the TTO method that tries to overcome some of the problems of the most widely used method (Torrance, 1986) for health states worse than death (SWD). Theoretically, the new method reduces the problems that have been detected when researchers have elicited preferences for SWD. However, several questions remain to be clarified. One of them is the influence of this new method for states better than death (SBD). In this paper we try to shed some light on this issue using a split sample design (n=500). One subsample (n=188) was interviewed using L-TTO and the rest using the traditional TTO (T-TTO). Our results show that the L-TTO produces utilities that are consistently higher than the T-TTO for SBD. Furthermore, the higher the severity the higher the difference between both methods. Another finding is that the L-TTO seems to produce a lower number of SWD. This effect seems to be concentrated in the most severe health states. This implies a violation of additive separability, one of the cornerstones of the QALY model. Our data show that the L-TTO may be different from the T-TTO in more respects than those that were originally intended.

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File URL: http://www.upo.es/serv/bib/wps/econ1110.pdf
File Function: First version, 2011
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Bibliographic Info

Paper provided by Universidad Pablo de Olavide, Department of Economics in its series Working Papers with number 11.10.

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Length: 23 pages
Date of creation: Dec 2011
Date of revision:
Handle: RePEc:pab:wpaper:11.10

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Keywords: Lead Time Trade-Off; QALYs; Discounting; Additive Independece;

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  1. 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.
  2. Charles M. Harvey, 1986. "Value Functions for Infinite-Period Planning," Management Science, INFORMS, vol. 32(9), pages 1123-1139, September.
  3. 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.
  4. van der Pol, Marjon & Cairns, John, 2002. "A comparison of the discounted utility model and hyperbolic discounting models in the case of social and private intertemporal preferences for health," Journal of Economic Behavior & Organization, Elsevier, vol. 49(1), pages 79-96, September.
  5. 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.
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