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The Lead Time Trade-Off: The case of health states better than death

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  • José Luis Pinto-Prades
  • Eva Rodríguez-Míguez

Abstract

The Lead Time Trade-Off (L-TTO) is a variant of the TTO method which attempts to overcome some of the problems of the most widely used method for health states worse than death (SWD). Theoretically, the new method reduces the problems 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). This paper attempts 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). The results show that the L-TTO produces utilities that are consistently higher than the T-TTO for SBD. Furthermore, the greater the severity, the greater is 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. The 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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Bibliographic Info

Paper provided by Universidade de Vigo, Departamento de Economía Aplicada in its series Working Papers with number 1101.

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Length: 23 pages
Date of creation: Nov 2011
Date of revision:
Handle: RePEc:vig:wpaper:1101

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Keywords: Lead TTO; states better than death; discounting.;

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  1. 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.
  2. 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.
  3. 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.
  4. Charles M. Harvey, 1986. "Value Functions for Infinite-Period Planning," Management Science, INFORMS, vol. 32(9), pages 1123-1139, 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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