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Deriving time discounting correction factors for TTO tariffs

  • Attema, Arthur
  • Brouwer, Werner

The Time Tradeoff (TTO) method is a popular method for valuing health state utilities and is frequently used in economic evaluations. However, this method produces utilities that are distorted by several biases. One important bias entails the failure to incorporate time discounting. This paper aims to measure time discounting for health outcomes in a sample representative for the general population. In particular, we estimate TTO scores alongside time discounting in order to derive a set of correction factors that can be employed to correct raw TTO scores for the downward bias caused by time discounting. We find substantial positive correction factors, which are increasing with the severity of the health state. Furthermore, higher discounting is found when using more severe health states in the discounting elicitation task. More research is needed to further develop discount rate elicitation procedures and test their validity, especially in general public samples. Moreover, future research should investigate the correction of TTO score for other biases as well, such as loss aversion, and to develop a criterion to test the external validity of TTO scores.

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Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 37002.

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Date of creation: 02 Feb 2012
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Handle: RePEc:pra:mprapa:37002
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  1. David Parkin & Nancy Devlin, 2006. "Is there a case for using visual analogue scale valuations in cost-utility analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 653-664.
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  4. Bleichrodt, Han, 2001. " Probability Weighting in Choice under Risk: An Empirical Test," Journal of Risk and Uncertainty, Springer, vol. 23(2), pages 185-98, September.
  5. van der Pol, Marjon & Cairns, John, 2008. "Comparison of two methods of eliciting time preference for future health states," Social Science & Medicine, Elsevier, vol. 67(5), pages 883-889, September.
  6. Linda D. MacKeigan & Amiram Gafni & Bernie J. O'Brien, 2003. "Double discounting of QALYs," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 165-169.
  7. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-91, March.
  8. van der Pol, Marjon & Cairns, John, 2001. "Estimating time preferences for health using discrete choice experiments," Social Science & Medicine, Elsevier, vol. 52(9), pages 1459-1470, May.
  9. Tversky, Amos & Kahneman, Daniel, 1992. " Advances in Prospect Theory: Cumulative Representation of Uncertainty," Journal of Risk and Uncertainty, Springer, vol. 5(4), pages 297-323, October.
  10. Peter Wakker & Daniel Deneffe, 1996. "Eliciting von Neumann-Morgenstern Utilities When Probabilities Are Distorted or Unknown," Management Science, INFORMS, vol. 42(8), pages 1131-1150, August.
  11. Hugh Gravelle & Werner Brouwer & Louis Niessen & Maarten Postma & Frans Rutten, 2007. "Discounting in economic evaluations: stepping forward towards optimal decision rules," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 307-317.
  12. Attema, Arthur E. & Brouwer, Werner B.F., 2009. "The correction of TTO-scores for utility curvature using a risk-free utility elicitation method," Journal of Health Economics, Elsevier, vol. 28(1), pages 234-243, January.
  13. Robinson, Angela & Dolan, Paul & Williams, Alan, 1997. "Valuing health status using VAS and TTO: What lies behind the numbers?," Social Science & Medicine, Elsevier, vol. 45(8), pages 1289-1297, October.
  14. Bleichrodt, Han & Johannesson, Magnus, 1997. "Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs," Journal of Health Economics, Elsevier, vol. 16(2), pages 155-175, April.
  15. Abellan-Perpiñan, Jose Maria & Bleichrodt, Han & Pinto-Prades, Jose Luis, 2009. "The predictive validity of prospect theory versus expected utility in health utility measurement," Journal of Health Economics, Elsevier, vol. 28(6), pages 1039-1047, December.
  16. van der Pol, Marjon & Cairns, John, 2002. "A comparison of the discounted utility model and hyperbolic discounting models in the case of social and private intertemporal preferences for health," Journal of Economic Behavior & Organization, Elsevier, vol. 49(1), pages 79-96, September.
  17. Chetan Dave & Catherine Eckel & Cathleen Johnson & Christian Rojas, 2010. "Eliciting risk preferences: When is simple better?," Journal of Risk and Uncertainty, Springer, vol. 41(3), pages 219-243, December.
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  22. Arthur E. Attema & Werner B. F. Brouwer, 2008. "Can we fix it? Yes we can! But what? A new test of procedural invariance in TTO-measurement," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 877-885.
  23. repec:oup:qjecon:v:106:y:1991:i:4:p:1039-61 is not listed on IDEAS
  24. Han Bleichrodt & Jose Maria Abellan-Perpiñan & Jose Luis Pinto-Prades & Ildefonso Mendez-Martinez, 2007. "Resolving Inconsistencies in Utility Measurement Under Risk: Tests of Generalizations of Expected Utility," Management Science, INFORMS, vol. 53(3), pages 469-482, March.
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