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Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff


  • Tracy A. Comans

    (University of Queensland
    NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People)

  • Kim-Huong Nguyen

    (University of Queensland
    NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People)

  • Julie Ratcliffe

    (Flinders University)

  • Donna Rowen

    (University of Sheffield)

  • Brendan Mulhern

    (University of Technology Sydney)


Objective This paper reports on the valuation of quality-of-life states in the Alzheimer’s Disease Five Dimensions (AD-5D) instrument in a representative sample of the general population in Australia using the discrete-choice experiment with duration (DCETTO) elicitation technique. Method A DCE with 200 choice sets of two quality-of-life (QoL) state–duration combinations blocked into 20 survey versions, with ten choice sets in each version, was designed and administered online to a sample representative of the Australian population. Two additional choice sets comprising internal consistency and dominance checks were included in each survey version. A range of model specifications investigating preferences with respect to duration and interactions between AD-5D dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale, suitable for the calculation of quality-adjusted life-year (QALY) weights for use in economic evaluation. Results In total, 1999 respondents completed the choice experiment. Overall, respondents were slightly better educated and had higher annual incomes than the Australian general population. The estimation results from different specifications and models were broadly consistent with the monotonic nature of the AD-5D: utility increased with increased life expectancy and decreased as the severity level for each dimension worsened. A utility value set was generated for the calculation of utilities for all QoL states defined by the AD-5D descriptive system. Conclusion The DCE-based utility value set is now available to use to generate QALYs for the economic evaluation of treatments and interventions targeting people with dementia and/or their family caregivers.

Suggested Citation

  • Tracy A. Comans & Kim-Huong Nguyen & Julie Ratcliffe & Donna Rowen & Brendan Mulhern, 2020. "Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff," PharmacoEconomics, Springer, vol. 38(8), pages 871-881, August.
  • Handle: RePEc:spr:pharme:v:38:y:2020:i:8:d:10.1007_s40273-020-00913-7
    DOI: 10.1007/s40273-020-00913-7

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    References listed on IDEAS

    1. Emily Lancsar & Denzil G. Fiebig & Arne Risa Hole, 2017. "Discrete Choice Experiments: A Guide to Model Specification, Estimation and Software," PharmacoEconomics, Springer, vol. 35(7), pages 697-716, July.
    2. G Torrance & Y Zhang & D Feeny & W Furlong & R Barr, 1992. "Multi-attribute Utility Functions for a Comprehensive Health Status Classification System: Health Utilities Index Mark 2," Centre for Health Economics and Policy Analysis Working Paper Series 1992-18, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 3rd August 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-08-03 11:00:00


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