title: Should Cost-Effectiveness Analysis Include the Cost of Consumption Activities? AN Empirical Investigation.
abstract: There has been a debate on whether cost-effectiveness analysis should consider the cost of consumption and leisure time activities when using the quality-adjusted life year as a measure of health outcome under a societal perspective. The purpose of this study was to investigate whether the effects of ill health on consumptive activities are spontaneously considered in a health state valuation exercise and how much this matters. The survey enrolled patients with inflammatory bowel disease in Germany (n = 104). Patients were randomized to explicit and no explicit instruction for the consideration of consumption and leisure effects in a time trade-off (TTO) exercise. Explicit instruction to consider non-health-related utility in TTO exercises did not influence TTO scores. However, spontaneous consideration of non-health-related utility in patients without explicit instruction (60% of respondents) led to significantly lower TTO scores. Results suggest an inclusion of consumption costs in the numerator of the cost-effectiveness ratio, at least for those respondents who spontaneously consider non-health-related utility from treatment. Results also suggest that exercises eliciting health valuations from the general public may include a description of the impact of disease on consumptive activities.
authors: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.|Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
authors: Charles Christian
authors: CC
authors: Adarkwah
authors: Management Department, Frankfurt School of Finance & Management, Frankfurt, Germany.
authors: Amirhossein
authors: A
authors: Sadoghi
authors: Management Department, Frankfurt School of Finance & Management, Frankfurt, Germany.
authors: Afschin
authors: A
authors: Gandjour
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D007899:Leisure Activities / Q000191:economics*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D019057:Quality-Adjusted Life Years; D013997:Time Factors; D055815:Young Adult
keywords: Crohn's disease; consumption; leisure time; quality-adjusted life year; time trade-off; ulcerative colitis; validation study