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Valuing health at the end of life: A stated preference discrete choice experiment


  • Shah, Koonal K.
  • Tsuchiya, Aki
  • Wailoo, Allan J.


A source of debate in the field of health care priority setting is whether health gains should be weighted differently for different groups of patients. The debate has recently focused on the relative value of life extensions for patients with short life expectancy. However, few studies have examined empirically whether society is prepared to fund life-extending end-of-life treatments that would not meet the reimbursement criteria used for other treatments.

Suggested Citation

  • Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
  • Handle: RePEc:eee:socmed:v:124:y:2015:i:c:p:48-56
    DOI: 10.1016/j.socscimed.2014.11.022

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    References listed on IDEAS

    1. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    2. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    3. Pinto-Prades, Jose-Luis & Sánchez-Martínez, Fernando-Ignacio & Corbacho, Belen & Baker, Rachel, 2014. "Valuing QALYs at the end of life," Social Science & Medicine, Elsevier, vol. 113(C), pages 5-14.
    4. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, March.
    5. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    6. Julia Witt & Anthony Scott & Richard H. Osborne, 2009. "Designing choice experiments with many attributes. An application to setting priorities for orthopaedic waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 681-696, June.
    7. Koonal Shah & Aki Tsuchiya & Allan Wailoo, 2014. "Valuing health at the end of life: an empirical study of public preferences," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(4), pages 389-399, May.
    8. E. Wetering & E. Stolk & N. Exel & W. Brouwer, 2013. "Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 107-115, February.
    9. Garau, M. & Shah, K. & Mason, A.R & Wang, Q. & Towse, A. & Drummond, M.F, 2010. "Using QALYs in Cancer: Review of the Methodological Limitations," Research Papers 000211, Office of Health Economics.
    10. Deborah Marshall & John Bridges & Brett Hauber & Ruthanne Cameron & Lauren Donnalley & Ken Fyie & F. Reed Johnson, 2010. "Conjoint Analysis Applications in Health — How are Studies being Designed and Reported?," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 3(4), pages 249-256, December.
    11. Emily Lancsar & Jordan Louviere, 2006. "Deleting ‘irrational’ responses from discrete choice experiments: a case of investigating or imposing preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 797-811, August.
    12. Colin Green & Karen Gerard, 2009. "Exploring the social value of health‐care interventions: a stated preference discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 951-976, August.
    13. Warren G. Linley & Dyfrig A. Hughes, 2013. "Societal Views On Nice, Cancer Drugs Fund And Value‐Based Pricing Criteria For Prioritising Medicines: A Cross‐Sectional Survey Of 4118 Adults In Great Britain," Health Economics, John Wiley & Sons, Ltd., vol. 22(8), pages 948-964, August.
    14. Paul Dolan & Aki Tsuchiya, 2011. "Determining the parameters in a social welfare function using stated preference data: an application to health," Applied Economics, Taylor & Francis Journals, vol. 43(18), pages 2241-2250.
    15. Towse, A. & Pritchard, C. & Devlin, N. eds, 2002. "Cost-Effectiveness Thresholds: Economic and ethical issues," Monographs, Office of Health Economics, number 000473, November.
    16. Shah, K. & Tsuchiya, A. & Wailoo, A., 2011. "Valuing Health at the End of Life: An Exploratory Preference Elicitation Study," Research Papers 000172, Office of Health Economics.
    17. Richardson, Jeff & McKie, John, 2005. "Empiricism, ethics and orthodox economic theory: what is the appropriate basis for decision-making in the health sector?," Social Science & Medicine, Elsevier, vol. 60(2), pages 265-275, January.
    18. Fredrik Carlsson & Peter Martinsson, 2003. "Design techniques for stated preference methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 281-294, April.
    Full references (including those not matched with items on IDEAS)


    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Thesis Thursday: Koonal Shah
      by Chris Sampson in The Academic Health Economists' Blog on 2017-11-16 13:00:09


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. McHugh, Neil & van Exel, Job & Mason, Helen & Godwin, Jon & Collins, Marissa & Donaldson, Cam & Baker, Rachel, 2018. "Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints," Social Science & Medicine, Elsevier, vol. 198(C), pages 61-69.
    2. Hampson, G. & Mott, D. & Devlin, N. & Shah, K., 2019. "Public Preferences for Health Gains and Cures: A Discrete Choice Experiment," Consulting Reports 002108, Office of Health Economics.
    3. Lancsar, Emily & Gu, Yuanyuan & Gyrd-Hansen, Dorte & Butler, Jim & Ratcliffe, Julie & Bulfone, Liliana & Donaldson, Cam, 2020. "The relative value of different QALY types," Journal of Health Economics, Elsevier, vol. 70(C).
    4. S. Olofsson & U.-G. Gerdtham & L. Hultkrantz & U. Persson, 2018. "Measuring the end-of-life premium in cancer using individual ex ante willingness to pay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 807-820, July.
    5. McHugh, Neil & Pinto-Prades, José Luis & Baker, Rachel & Mason, Helen & Donaldson, Cam, 2020. "Exploring the relative value of end of life QALYs: Are the comparators important?," Social Science & Medicine, Elsevier, vol. 245(C).
    6. Shah, K. & Chapman, A. & Devlin, N. & Barnsley, P., 2015. "Do Respondents Completing Abstract, Hypothetical Priority-setting Exercises Agree With the Policy Implications of Their Choices?," Consulting Reports 001576, Office of Health Economics.
    7. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2018. "Valuing health at the end of life: A review of stated preference studies in the social sciences literature," Social Science & Medicine, Elsevier, vol. 204(C), pages 39-50.
    8. Hansen, Lise Desireé & Kjær, Trine, 2019. "Disentangling public preferences for health gains at end-of-life: Further evidence of no support of an end-of-life premium," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    9. Christopher McCabe & Ash Paul & Greg Fell & Mike Paulden, 2016. "Cancer Drugs Fund 2.0: A Missed Opportunity?," PharmacoEconomics, Springer, vol. 34(7), pages 629-633, July.
    10. Chamberlain, Charlotte & Owen-Smith, Amanda & MacKichan, Fiona & Donovan, Jenny L. & Hollingworth, William, 2019. "“What’s fair to an individual is not always fair to a population”: A qualitative study of patients and their health professionals using the Cancer Drugs Fund," Health Policy, Elsevier, vol. 123(8), pages 706-712.

    More about this item


    UK; End of life; NICE; Public preferences; Severity; Priority setting; Discrete choice experiment; Health economics;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health


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