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Efficiency And Equity: A Stated Preference Approach

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  • Richard Norman
  • Jane Hall
  • Deborah Street
  • Rosalie Viney

Abstract

Outcome measurement in the economic evaluation of health care considers outcomes independent of to whom they accrue. This article reports on a discrete choice experiment designed to elicit population preferences regarding the allocation of health gain between hypothetical groups of potential patients. A random‐effects probit model is estimated, and a technique for converting these results into equity weights for use in economic evaluation is adopted. On average, the modelling predicts a relatively high social value on health gains accruing to nonsmokers, carers, those with a low income and those with an expected age of death less than 45 years. Respondents tend to favour individuals with similar characteristics to themselves. These results challenge the conventional practice of assuming constant equity weighting. For decision makers, whether a formal equity weighting system represents an improvement on more informal approaches to weighing up equity and efficiency concerns remains uncertain. Copyright © 2012 John Wiley & Sons, Ltd.

Suggested Citation

  • Richard Norman & Jane Hall & Deborah Street & Rosalie Viney, 2013. "Efficiency And Equity: A Stated Preference Approach," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 568-581, May.
  • Handle: RePEc:wly:hlthec:v:22:y:2013:i:5:p:568-581
    DOI: 10.1002/hec.2827
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    References listed on IDEAS

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    1. Richard Norman & Gisselle Gallego, 2008. "Equity weights for economic evaluation: An Australian Discrete Choice Experiment, CHERE Working Paper 2008/5," Working Papers 2008/5, CHERE, University of Technology, Sydney.
    2. J.M.C. Santos Silva, 2004. "Deriving welfare measures in discrete choice experiments: a comment to Lancsar and Savage (2)," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 913-918, September.
    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. Lancsar, Emily & Wildman, John & Donaldson, Cam & Ryan, Mandy & Baker, Rachel, 2011. "Deriving distributional weights for QALYs through discrete choice experiments," Journal of Health Economics, Elsevier, vol. 30(2), pages 466-478, March.
    5. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-114, November.
    6. Tobin, James, 1970. "On Limiting the Domain of Inequality," Journal of Law and Economics, University of Chicago Press, vol. 13(2), pages 263-277, October.
    7. Denzil G. Fiebig & Michael P. Keane & Jordan Louviere & Nada Wasi, 2010. "The Generalized Multinomial Logit Model: Accounting for Scale and Coefficient Heterogeneity," Marketing Science, INFORMS, vol. 29(3), pages 393-421, 05-06.
    8. McIntosh, E. & Ryan, M., 2002. "Using discrete choice experiments to derive welfare estimates for the provision of elective surgery: Implications of discontinuous preferences," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 367-382, June.
    9. Hall, Jane & Fiebig, Denzil G. & King, Madeleine T. & Hossain, Ishrat & Louviere, Jordan J., 2006. "What influences participation in genetic carrier testing?: Results from a discrete choice experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 520-537, May.
    10. Lancsar, Emily & Louviere, Jordan & Flynn, Terry, 2007. "Several methods to investigate relative attribute impact in stated preference experiments," Social Science & Medicine, Elsevier, vol. 64(8), pages 1738-1753, April.
    11. 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.
    12. Olsen, Jan Abel & Richardson, Jeff & Dolan, Paul & Menzel, Paul, 2003. "The moral relevance of personal characteristics in setting health care priorities," Social Science & Medicine, Elsevier, vol. 57(7), pages 1163-1172, October.
    13. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907, September.
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    Cited by:

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    2. Whitty, Jennifer A. & Littlejohns, Peter, 2015. "Social values and health priority setting in Australia: An analysis applied to the context of health technology assessment," Health Policy, Elsevier, vol. 119(2), pages 127-136.
    3. E. Wetering & N. Exel & J. Rose & R. Hoefman & W. Brouwer, 2016. "Are some QALYs more equal than others?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 117-127, March.
    4. Anita Lal & Mohammad Siahpush & Marjory Moodie & Anna Peeters & Robert Carter, 2018. "Weighting Health Outcomes by Socioeconomic Position Using Stated Preferences," PharmacoEconomics - Open, Springer, vol. 2(1), pages 43-51, March.
    5. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    6. Shehzad Ali & Aki Tsuchiya & Miqdad Asaria & Richard Cookson, 2017. "How Robust Are Value Judgments of Health Inequality Aversion? Testing for Framing and Cognitive Effects," Medical Decision Making, , vol. 37(6), pages 635-646, August.
    7. Chris Skedgel & Allan Wailoo & Ron Akehurst, 2015. "Societal Preferences for Distributive Justice in the Allocation of Health Care Resources," Medical Decision Making, , vol. 35(1), pages 94-105, January.
    8. Jennifer Whitty & Emily Lancsar & Kylie Rixon & Xanthe Golenko & Julie Ratcliffe, 2014. "A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(4), pages 365-386, December.
    9. Jennifer A Whitty & Ruth Walker & Xanthe Golenko & Julie Ratcliffe, 2014. "A Think Aloud Study Comparing the Validity and Acceptability of Discrete Choice and Best Worst Scaling Methods," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    10. LUYTEN, Jeroen & KESSELS, Roselinde & GOOS, Peter & BEUTELS, Philippe, 2013. "Public preferences for prioritizing preventive and curative health care interventions: A discrete choice experiment," Working Papers 2013032, University of Antwerp, Faculty of Business and Economics.
    11. Liesbet Wetering & Job Exel & Ana Bobinac & Werner Brouwer, 2015. "Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 33(12), pages 1289-1300, December.
    12. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    13. Stuart J. Wright & Mike Paulden & Katherine Payne, 2020. "Implementing Interventions with Varying Marginal Cost-Effectiveness: An Application in Precision Medicine," Medical Decision Making, , vol. 40(7), pages 924-938, October.
    14. Simon McNamara & John Holmes & Abigail K. Stevely & Aki Tsuchiya, 2020. "How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 275-285, March.

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