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Making Composite Time Trade-Off Sensitive for Worse-than-Dead Health States

Author

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  • Michał Jakubczyk

    (SGH Warsaw School of Economics)

  • Bram Roudijk

    (EuroQol Research Foundation)

  • Stefan A. Lipman

    (Erasmus University Rotterdam)

  • Peep Stalmeier

    (Radboud University Medical Center)

Abstract

Objective The utilities elicited with the composite time trade-off (cTTO) method for health states worse-than-dead (WTD) often correlate poorly with other severity measures, indicating a poor sensitivity of cTTO. We aimed to explore modifications to cTTO to better understand this phenomenon and identify potential improvements. Methods A total of 480 respondents completed an online TTO interview, each valuing 12 EQ-5D-5L health states. The participants were randomized into four arms, A–D. Arm A followed the standard cTTO, serving as a reference. In arm B, we removed the sorting question comparing immediate death versus 10 years in a valued state. Arm C allowed for utility values $$

Suggested Citation

  • Michał Jakubczyk & Bram Roudijk & Stefan A. Lipman & Peep Stalmeier, 2025. "Making Composite Time Trade-Off Sensitive for Worse-than-Dead Health States," PharmacoEconomics, Springer, vol. 43(6), pages 665-675, June.
    • Handle: RePEc:spr:pharme:v:43:y:2025:i:6:d:10.1007_s40273-025-01471-6
    DOI: 10.1007/s40273-025-01471-6
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