Should patients have a greater role in valuing health states?
Currently, health state values are usually obtained from members of the general public trying to imagine what the state would be like rather than by patients who are actually in the various states of health. Valuations of a health state by patients tend to vary from those of the general population, and this seems to be due to a range of factors including errors in the descriptive system, adaptation to the state and changes in internal standards. The question of whose values are used in cost-effectiveness analysis is ultimately a normative one, but the decision should be informed by evidence on the reasons for the differences. There is a case for obtaining better informed general population preferences by providing more information on what it is like for patients (including the process of adaptation).
Brazier
John
J
Health Economics and Decision Science, University of Sheffield, Sheffield, UK. j.e.brazier@sheffield.ac.uk
Akehurst
Ron
R
Brennan
Alan
A
Dolan
Paul
P
Claxton
Karl
K
McCabe
Chris
C
Sculpher
Mark
M
Tsuchyia
Aki
A
D000223:Adaptation, Psychological; D001294:Attitude to Health; D003362:Cost-Benefit Analysis / Q000379:methods; D004739:England; D006291:Health Policy; D006304:Health Status; D006801:Humans; D017060:Patient Satisfaction / Q000191:economics / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation; D018570:Risk Assessment; D018434:Sickness Impact Profile; D012946:Social Welfare / Q000191:economics; D026712:Value of Life / Q000191:economics; D014852:Wales