The Impact of Different DCE-Based Approaches When Anchoring Utility Scores

Norman, R; Mulhern, B; Viney, R

The Impact of Different DCE-Based Approaches When Anchoring Utility Scores

Norman, R

Mulhern, B

Viney, R

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Publication Type:: Journal Article
Citation:: PharmacoEconomics, 2016, 34 (8), pp. 805 - 814
Issue Date:: 2016-08-01

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Field	Value	Language
dc.contributor.author	Norman, R https://orcid.org/0000-0002-3112-3893	en_US
dc.contributor.author	Mulhern, B https://orcid.org/0000-0003-3656-8063	en_US
dc.contributor.author	Viney, R https://orcid.org/0000-0002-0039-9635	en_US
dc.date.issued	2016-08-01	en_US
dc.identifier.citation	PharmacoEconomics, 2016, 34 (8), pp. 805 - 814	en_US
dc.identifier.issn	1170-7690	en_US
dc.identifier.uri	http://hdl.handle.net/10453/102340
dc.description.abstract	© 2016, Springer International Publishing Switzerland. Background: Discrete choice experiments (DCEs) have been proposed as a method to estimate utility weights for health states within utility instruments. However, the most appropriate method to anchor the utility values on the full health to dead quality-adjusted life year (QALY) scale remains uncertain. We test four approaches to anchoring in which dead is valued at zero and full health at one. Methods: We use data from two DCEs valuing EQ-5D-3L and EQ-5D-5L health states, which presented pairs of health profiles with an associated duration, and a dead option. The approaches to anchoring the results on the required scale were (1) using only preferences between non-dead health profiles; (2) including the dead data, treating it as a health profile with zero duration; (3) explicitly modelling both duration and dead; and (4) using the preferences regarding the dead health state as an external anchor subsequent to the estimation of approach 1. Results: All approaches lead to differences in the scale of utility decrements, but not the ranking of EQ-5D health states. The models differ in their ability to predict preferences around dead health states, and the characteristics of the value sets in terms of their range and the proportion of states valued as worse than dead. Discussion: Appropriate anchoring of DCEs with or without complementary time trade-off (TTO) data remains unresolved, and the method chosen will impact on health resource allocation decision making employing the value sets.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/403303
dc.relation.ispartof	PharmacoEconomics	en_US
dc.relation.isbasedon	10.1007/s40273-016-0399-7	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Models, Statistical	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Choice Behavior	en_US
dc.subject.mesh	Health Status	en_US
dc.subject.mesh	Quality-Adjusted Life Years	en_US
dc.subject.mesh	Models, Theoretical	en_US
dc.subject.mesh	Resource Allocation	en_US
dc.subject.mesh	Patient Preference	en_US
dc.title	The Impact of Different DCE-Based Approaches When Anchoring Utility Scores	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	34	en_US
utslib.for	140208 Health Economics	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	14 Economics	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	34	en_US

Abstract:

© 2016, Springer International Publishing Switzerland. Background: Discrete choice experiments (DCEs) have been proposed as a method to estimate utility weights for health states within utility instruments. However, the most appropriate method to anchor the utility values on the full health to dead quality-adjusted life year (QALY) scale remains uncertain. We test four approaches to anchoring in which dead is valued at zero and full health at one. Methods: We use data from two DCEs valuing EQ-5D-3L and EQ-5D-5L health states, which presented pairs of health profiles with an associated duration, and a dead option. The approaches to anchoring the results on the required scale were (1) using only preferences between non-dead health profiles; (2) including the dead data, treating it as a health profile with zero duration; (3) explicitly modelling both duration and dead; and (4) using the preferences regarding the dead health state as an external anchor subsequent to the estimation of approach 1. Results: All approaches lead to differences in the scale of utility decrements, but not the ranking of EQ-5D health states. The models differ in their ability to predict preferences around dead health states, and the characteristics of the value sets in terms of their range and the proportion of states valued as worse than dead. Discussion: Appropriate anchoring of DCEs with or without complementary time trade-off (TTO) data remains unresolved, and the method chosen will impact on health resource allocation decision making employing the value sets.

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http://hdl.handle.net/10453/102340