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Valuing Health at the End of Life: A Stated Preference Discrete Choice Experiment

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  • Shah, K.
  • Tsuchiya, A.
  • Risa Hole, A.
  • Wailoo, A.

Abstract

In 2009, the UK's National Institute for Health and Clinical Excellence (NICE) issued supplementary advice that its Appraisal Committees are to consider when assessing treatments that extend life at the end of life. This includes an option for approving such treatments for use in the NHS if certain criteria are met, even if base case cost-effectiveness estimates exceed the range usually considered acceptable. The policy thus places additional weight on the survival benefits for a small numbers of patients with terminal illnesses and short life expectancies. It assumes that this accurately reflects the preferences of the general public. However, little scientific evidence is available to support that premise. With funding from NICE's Decision Support Unit, Koonal Shah of the OHE has collaborated with Aki Tsuchiya, Arne Risa Hole and Allan Wailoo of the University of Sheffield to conduct research to help fill this void. A discrete choice experiment was conducted in March 2012 with a sample of 3,969 members of the general public in England and Wales. In reporting the results of the research, the authors state that - 'Overall, the results of this study do not suggest that the cut-offs implied by the existing NICE supplementary end of life policy require amending, and in fact call into question whether such a policy of giving higher priority to end of life treatments than to other types of treatments is supported by the public at all, particularly if the health gains offered by the treatments being 'de-prioritised' are larger than those offered by the end of life treatments.' A revised version of this paper has been published in Social Science & Medicine and can be downloaded from - http://www.sciencedirect.com/science/article/pii/S027795361400745X Please cite as - Shah, K. K., Tsuchiya, A. and Wailoo, A. J., 2015. Valuing health at the end of life - A stated preference discrete choice experiment. Social Science & Medicine, 124, pp.48-56.

Suggested Citation

  • Shah, K. & Tsuchiya, A. & Risa Hole, A. & Wailoo, A., 2012. "Valuing Health at the End of Life: A Stated Preference Discrete Choice Experiment," Research Papers 000132, Office of Health Economics.
  • Handle: RePEc:ohe:respap:000132
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    References listed on IDEAS

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    12. 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.
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    15. 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.
    16. 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.
    17. 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.
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    Blog mentions

    As found by EconAcademics.org, 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

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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Baker, Rachel & Mason, Helen & McHugh, Neil & Donaldson, Cam, 2021. "Public values and plurality in health priority setting: What to do when people disagree and why we should care about reasons as well as choices," Social Science & Medicine, Elsevier, vol. 277(C).
    7. 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).
    8. 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.
    9. 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).
    10. Na-na Wang & Liang-guo Luo & Ya-ru Pan & Xue-mei Ni, 2019. "Use of discrete choice experiments to facilitate design of effective environmentally friendly agricultural policies," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 21(4), pages 1543-1559, August.
    11. 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.
    12. Andrew Briggs, 2016. "A View from the Bridge: Health Economic Evaluation — A Value‐Based Framework?," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1499-1502, December.
    13. 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.
    14. 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.
    15. Dorte Gyrd‐Hansen, 2018. "Is there additional value attached to health gains at the end of life? A revisit," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 71-75, January.

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    More about this item

    Keywords

    Judging value for money and improving decision making;

    JEL classification:

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

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