Health-state valuations for pertussis: methods for valuing short-term health states.
BACKGROUND
The incidence of reported adolescent and adult pertussis continues to rise in the United States. Acellular pertussis vaccines for adolescents and adults have been developed and may be available soon for use in the U.S. Our objectives were: (1) to describe patient valuations of pertussis disease and vaccination; and (2) to compare valuations for short-term and long-term health states associated with pertussis.


METHODS
We conducted telephone surveys with 515 adult patients and parents of adolescent patients with pertussis in Massachusetts to determine valuations of pertussis-related health states for disease and vaccination using time trade-off (TTO) and contingent valuation (CV) techniques. Respondents were randomized to complete either a short-term or long-term TTO exercise. Discrimination between health states for each valuation technique was assessed using Tukey's method, and valuations for short-term vs. long-term health states were compared using the Wilcoxon rank-sum test.


RESULTS
Three hundred three (59%) and 309 (60%) respondents completed and understood the TTO and CV exercises, respectively. Overall, respondents gave lower valuations (lower TTO and higher CV values) to avoid a given state for adolescent/adult disease compared to vaccine adverse events. Infant complications due to pertussis were considered worse than adolescent/adult disease, regardless of the method of valuation. The short-term TTO resulted in lower mean valuations and larger mean differences between health states than the long-term TTO exercise.


CONCLUSIONS
Pertussis was considered worse than adverse events due to vaccination. Short-term health-state valuation is better able to discriminate among health states, which is useful for cost-utility analysis.
Lee
Grace M
GM
Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, 133 Brookline Ave, 6th floor, Boston, MA 02215, USA. grace_lee@hphc.org
Salomon
Joshua A
JA
LeBaron
Charles W
CW
Lieu
Tracy A
TA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002755:Choice Behavior; D002908:Chronic Disease; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D013997:Time Factors; D026712:Value of Life / Q000191:economics*; D014917:Whooping Cough / Q000191:economics / Q000503:physiopathology* / Q000517:prevention & control
D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines