IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v13y2004i2p171-181.html
   My bibliography  Save this article

Lack of multiplicative transitivity in person trade‐off responses

Author

Listed:
  • Michaël Schwarzinger
  • Jean‐Louis Lanoë
  • Erik Nord
  • Isabelle Durand‐Zaleski

Abstract

Background: The person trade‐off (PTO) is a technique for eliciting preferences for resource allocation across patient groups. In principle PTO responses should satisfy a requirement of multiplicative transitivity, i.e. that if people consider treatment of 1 in state A to be equivalent to treating 10 in state B, and 1 in state B to be equivalent to 10 in state C, then they should find 1 in state A equivalent to 100 in state C. Earlier studies addressing labelled diseases (specific diagnoses), have shown multiplicative intransitivity of the PTO responses. Our purpose was to test multiplicative transitivity in the case of health states described with the EuroQol instrument only and to find a possible framing effect such as the number of persons in the reference intervention. Methods: Forty‐four master degree students were asked to fill in a questionnaire addressing four chronic health states. Their task consisted in (1) ranking the states by severity, (2) valuing each of them by the means of the time trade‐off, and (3) doing the PTO for all the 10 possible pairwise combinations of the four chronic states plus a fatal one. In a subsequent questionnaire the number of persons in the reference intervention in the PTO was increased from 10 to 100. Multiplicative transitivity was studied in subjects who demonstrated a willingness to trade off and consistency in ranking individual values. Results: None of the 39 subjects included satisfied a minimum multiplicative transitivity requirement in PTO responses. Internal consistency was not improved when the PTO involved health states close to each other in terms of severity, nor when the prevention of death was not the reference intervention. For the 22 subjects having answered both types of questionnaire, increasing the number of persons in the reference intervention did not improve multiplicative transitivity. Conclusions: The PTO holds promise as a useful method for determining social preferences for priority setting, inasmuch as it captures distributive concerns that individual utility techniques such as the time trade‐off do not address. But the lack of multiplicative transitivity in PTO responses is unsatisfactory, and ways to reduce this problem need to be explored. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
  • Handle: RePEc:wly:hlthec:v:13:y:2004:i:2:p:171-181
    DOI: 10.1002/hec.808
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.808
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.808?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Brooks, Richard AU -, 1996. "EuroQol: the current state of play," Health Policy, Elsevier, vol. 37(1), pages 53-72, July.
    2. Nord, Erik, 1993. "Unjustified use of the quality of well-being scale in priority setting in Oregon," Health Policy, Elsevier, vol. 24(1), pages 45-53, April.
    3. Ubel, Peter A. & Loewenstein, George & Scanlon, Dennis & Kamlet, Mark, 1998. "Value measurement in cost-utility analysis: explaining the discrepancy between rating scale and person trade-off elicitations," Health Policy, Elsevier, vol. 43(1), pages 33-44, January.
    4. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    5. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132, March.
    6. Melse, J.M. & Essink-Bot, M.-L. & Kramers, P.G.N. & Hoeymans, N., 2000. "A national burden of disease calculation: Dutch disability-adjusted life-years," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1241-1247.
    7. Kevin J. Boyle & Richard C. Bishop & Michael P. Welsh, 1985. "Starting Point Bias in Contingent Valuation Bidding Games," Land Economics, University of Wisconsin Press, vol. 62(2), pages 188-194.
    8. Ham, Chris, 1997. "Priority setting in health care: learning from international experience," Health Policy, Elsevier, vol. 42(1), pages 49-66, October.
    9. Andrew R. Willan & Bernie J. O'Brien, 1999. "Sample size and power issues in estimating incremental cost‐effectiveness ratios from clinical trials data," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 203-211, May.
    10. Nord, Erik, 1993. "The trade-off between severity of illness and treatment effect in cost-value analysis of health care," Health Policy, Elsevier, vol. 24(3), pages 227-238, August.
    11. John Brazier & Mark Deverill, 1999. "A checklist for judging preference‐based measures of health related quality of life: Learning from psychometrics," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 41-51, February.
    12. Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    13. Nord, Erik, 1992. "Methods for quality adjustment of life years," Social Science & Medicine, Elsevier, vol. 34(5), pages 559-569, March.
    14. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    15. Eva Rodríguez‐Míguez & José‐Luis Pinto‐Prades, 2002. "Measuring the social importance of concentration or dispersion of individual health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 43-53, January.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. Lars Østerdal, 2009. "The lack of theoretical support for using person trade-offs in QALY-type models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(4), pages 429-436, October.
    2. 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.
    3. Jeff Richardson & John McKie & Stuart Peacock & Angelo Iezzi, 2011. "Severity as an independent determinant of the social value of a health service," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 163-174, April.
    4. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    5. Jeff Richardson & Angelo Iezzi & Kompal Sinha & Munir A. Khan & John Mckie, 2014. "An Instrument For Measuring The Social Willingness To Pay For Health State Improvement," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 792-805, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Peter A. Ubel & Jeff Richardson & Paul Menzel, 2000. "Societal value, the person trade‐off, and the dilemma of whose values to measure for cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 127-136, March.
    2. Colin Green, 2001. "On the societal value of health care: what do we know about the person trade‐off technique?," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 233-243, April.
    3. 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.
    4. Erik Nord & Rune Johansen, 2015. "Transforming EQ-5D utilities for use in cost–value analysis of health programs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 313-328, April.
    5. Juan Manuel Cabasés & Idoia Gaminde & José M. Ugalde, 2000. "Societal perspective on the eliciting of health states preferences," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 0010, Departamento de Economía - Universidad Pública de Navarra.
    6. Erik Nord, 2015. "Cost-Value Analysis of Health Interventions: Introduction and Update on Methods and Preference Data," PharmacoEconomics, Springer, vol. 33(2), pages 89-95, February.
    7. Richardson, Jeff & Sinha, Kompal & Iezzi, Angelo & Maxwell, Aimee, 2012. "Maximising health versus sharing: Measuring preferences for the allocation of the health budget," Social Science & Medicine, Elsevier, vol. 75(8), pages 1351-1361.
    8. Mæstad, Ottar & Norheim, Ole Frithjof, 2009. "Eliciting people's preferences for the distribution of health: A procedure for a more precise estimation of distributional weights," Journal of Health Economics, Elsevier, vol. 28(3), pages 570-577, May.
    9. 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.
    10. Lars Peter Østerdal, 2003. "A note on cost‐value analysis," Health Economics, John Wiley & Sons, Ltd., vol. 12(3), pages 247-250, March.
    11. Patrick Hofstetter & James K. Hammitt, 2002. "Selecting Human Health Metrics for Environmental Decision‐Support Tools," Risk Analysis, John Wiley & Sons, vol. 22(5), pages 965-983, October.
    12. Lars Østerdal, 2009. "The lack of theoretical support for using person trade-offs in QALY-type models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(4), pages 429-436, October.
    13. Robberstad, Bjarne & Norheim, Ole F., 2011. "Incorporating concerns for equal lifetime health in evaluations of public health programs," Social Science & Medicine, Elsevier, vol. 72(10), pages 1711-1716, May.
    14. Aki Tsuchiya & Richard Edlin & Paul Dolan, 2009. "Measuring the societal value of lifetime health," Working Papers 2009010, The University of Sheffield, Department of Economics, revised May 2009.
    15. Pieter H. M. van Baal & Talitha L. Feenstra & Rudolf T. Hoogenveen & G. Ardine de Wit & Werner B. F. Brouwer, 2007. "Unrelated medical care in life years gained and the cost utility of primary prevention: in search of a ‘perfect’ cost–utility ratio," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 421-433, April.
    16. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    17. Cappelen, Alexander W. & Norheim, Ole Frithjof, 2006. "Responsibility, fairness and rationing in health care," Health Policy, Elsevier, vol. 76(3), pages 312-319, May.
    18. Mira Johri & Laura J. Damschroder & Brian J. Zikmund‐Fisher & Peter A. Ubel, 2005. "The importance of age in allocating health care resources: does intervention‐type matter?," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 669-678, July.
    19. Murray, Christopher J. L. & Acharya, Arnab K., 1997. "Understanding DALYs," Journal of Health Economics, Elsevier, vol. 16(6), pages 703-730, December.
    20. Damschroder, Laura J. & Zikmund-Fisher, Brian J. & Ubel, Peter A., 2005. "The impact of considering adaptation in health state valuation," Social Science & Medicine, Elsevier, vol. 61(2), pages 267-277, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:13:y:2004:i:2:p:171-181. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.