IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v41y2023i8d10.1007_s40273-023-01266-7.html
   My bibliography  Save this article

How Much Better is Faster? Value Adjustments for Health-Improvement Sequences

Author

Listed:
  • F. Reed Johnson

    (Duke University School of Medicine)

  • Juan Marcos Gonzalez

    (Duke University School of Medicine)

  • John J. Sheehan

    (Janssen Scientific Affairs)

  • Shelby D. Reed

    (Duke University School of Medicine)

Abstract

While the quality-adjusted life-year construct has advantages of simplicity and consistency, simplicity requires strong assumptions. In particular, standard assumptions result in health-state utility functions that are unrealistically linear and separable in risk and duration. Consequently, sequencing of a series of health improvements has no effect on the total value of the sequence because each increment is assessed independently of previous increments. Utility functions in nearly all other areas of applied economics are assumed to be nonlinear with diminishing marginal utility so it matters where an improvement occurs in a sequence. We construct a conceptual framework that that demonstrates how diminishing marginal utility for health improvements could affect preferences for different sequence patterns. Using this framework, we derive conditions for which the sum of conventional health-state utilities understates, overstates, or approximates the sequence-sensitive value of health improvements. These patterns suggest the direction and magnitude of possible adjustments to conventional value calculations. We provide numerical examples and identify recent studies whose results are consistent with the conceptual model.

Suggested Citation

  • F. Reed Johnson & Juan Marcos Gonzalez & John J. Sheehan & Shelby D. Reed, 2023. "How Much Better is Faster? Value Adjustments for Health-Improvement Sequences," PharmacoEconomics, Springer, vol. 41(8), pages 845-856, August.
    • Handle: RePEc:spr:pharme:v:41:y:2023:i:8:d:10.1007_s40273-023-01266-7
    DOI: 10.1007/s40273-023-01266-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-023-01266-7
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40273-023-01266-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Sylvie M. C. van Osch & Peter P. Wakker & Wilbert B. van den Hout & Anne M. Stiggelbout, 2004. "Correcting Biases in Standard Gamble and Time Tradeoff Utilities," Medical Decision Making, , vol. 24(5), pages 511-517, October.
    2. Winter, Laraine & Parker, Barbara, 2007. "Current health and preferences for life-prolonging treatments: An application of prospect theory to end-of-life decision making," Social Science & Medicine, Elsevier, vol. 65(8), pages 1695-1707, October.
    3. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    4. Mohan V. Bala & Gary A. Zarkin, 2000. "Are QALYs an appropriate measure for valuing morbidity in acute diseases?," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 177-180, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. van der Pol, Marjon & Ruggeri, Matteo, 2008. "Is risk attitude outcome specific within the health domain?," Journal of Health Economics, Elsevier, vol. 27(3), pages 706-717, May.
    3. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier, 2013. "Prospect theory in the health domain: A quantitative assessment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1057-1065.
    4. Hammitt, James K. & Haninger, Kevin, 2017. "Valuing nonfatal health risk as a function of illness severity and duration: Benefit transfer using QALYs," Journal of Environmental Economics and Management, Elsevier, vol. 82(C), pages 17-38.
    5. Kristian Schultz Hansen & Lars Peter Østerdal, 2006. "Models of Quality‐Adjusted Life Years when Health Varies Over Time: Survey and Analysis," Journal of Economic Surveys, Wiley Blackwell, vol. 20(2), pages 229-255, April.
    6. Stefan A. Lipman & Werner B.F. Brouwer & Arthur E. Attema, 2019. "QALYs without bias? Nonparametric correction of time trade‐off and standard gamble weights based on prospect theory," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 843-854, July.
    7. Spencer, Anne & Rivero-Arias, Oliver & Wong, Ruth & Tsuchiya, Aki & Bleichrodt, Han & Edwards, Rhiannon Tudor & Norman, Richard & Lloyd, Andrew & Clarke, Philip, 2022. "The QALY at 50: One story many voices," Social Science & Medicine, Elsevier, vol. 296(C).
    8. A. Freeman, 2006. "Valuing Environmental Health Effects – An Economic Perspective," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 34(3), pages 347-363, July.
    9. Stefan A. Lipman & Arthur E. Attema & Matthijs M. Versteegh, 2022. "Correcting for discounting and loss aversion in composite time trade‐off," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1633-1648, August.
    10. Bengt Liljas, 2011. "Welfare, QALYs, and costs – a comment," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 68-72, January.
    11. Ryan Edwards, 2013. "The cost of uncertain life span," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(4), pages 1485-1522, October.
    12. Lars Peter Østerdal, 2004. "Exponential Health Utility: A Characterization and Comments on a Paper by Happich and Mühlbacher," Discussion Papers 04-04, University of Copenhagen. Department of Economics.
    13. Gordon Hazen, 2004. "Multiattribute Structure for QALYs," Decision Analysis, INFORMS, vol. 1(4), pages 205-216, December.
    14. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    15. Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
    16. Anna Scherbina, 2021. "Assessing the Optimality of a COVID Lockdown in the United States," Economics of Disasters and Climate Change, Springer, vol. 5(2), pages 177-201, July.
    17. Attema, Arthur E. & l’Haridon, Olivier & van de Kuilen, Gijs, 2019. "Measuring multivariate risk preferences in the health domain," Journal of Health Economics, Elsevier, vol. 64(C), pages 15-24.
    18. Johannesson, Magnus, 1995. "Qalys: A comment," Journal of Public Economics, Elsevier, vol. 56(2), pages 327-328, February.
    19. Yuval Rottenstreich & Alex Markle & Johannes Müller-Trede, 2023. "Risky Sure Things," Management Science, INFORMS, vol. 69(8), pages 4707-4720, August.
    20. Kvamme, Maria Knoph & Gyrd-Hansen, Dorte & Olsen, Jan Abel & Kristiansen, Ivar Sønbø, 2010. "Increasing marginal utility of small increases in life-expectancy?: Results from a population survey," Journal of Health Economics, Elsevier, vol. 29(4), pages 541-548, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:41:y:2023:i:8:d:10.1007_s40273-023-01266-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.