IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v12y2003i2p165-169.html
   My bibliography  Save this article

Double discounting of QALYs

Author

Listed:
  • Linda D. MacKeigan
  • Amiram Gafni
  • Bernie J. O'Brien

Abstract

Quality‐adjusted life‐years (QALYs) calculated from time tradeoff (TTO) based preferences have a time preference component. To impose a conventional discount rate on these implicitly discounted QALYs introduces some degree of double discounting. The purpose of this study was to determine the magnitude of the double discounting effect and the effectiveness of a suggested method for avoiding double discounting in a TTO‐based QALY model. Our analysis used holistic and composite preference scores obtained with the TTO technique in a prior study of four hypothetical treatment paths in type 2 diabetes. Discounted composite preference scores were significantly discrepant from holistic preference scores. Adjusting TTO‐based quality weights prior to external discounting reduced the discrepancy only slightly. Since time preference effects may vary with health state context, the double discounting effect needs further investigation. Copyright © 2002 John Wiley & Sons, Ltd.

Suggested Citation

  • Linda D. MacKeigan & Amiram Gafni & Bernie J. O'Brien, 2003. "Double discounting of QALYs," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 165-169, February.
    • Handle: RePEc:wly:hlthec:v:12:y:2003:i:2:p:165-169
    DOI: 10.1002/hec.718
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.718
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.718?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
    ---><---

    References listed on IDEAS

    as
    1. Peter J. Neumann & Darren E. Zinner & Janice C. Wright, 1997. "Are Methods for Estimating QALYs in Cost-Effectiveness Analyses Improving?," Medical Decision Making, , vol. 17(4), pages 402-408, October.
    2. Mehrez, Abraham & Gafni, Amiram, 1990. "Evaluating health related quality of life: An indifference curve interpretation for the time trade-off technique," Social Science & Medicine, Elsevier, vol. 31(11), pages 1281-1283, January.
    3. Hammitt, James K., 1993. "Discounting health increments," Journal of Health Economics, Elsevier, vol. 12(1), pages 117-120, April.
    4. Marjon M. Van Der Pol & John A. Cairns, 2000. "Negative and zero time preference for health," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 171-175, March.
    5. Amiram Gafni & George W. Torrance, 1984. "Risk Attitude and Time Preference in Health," Management Science, INFORMS, vol. 30(4), pages 440-451, April.
    6. A Mehrez & A Gafni, 1990. "Evaluating Health Related Quality-of-life: An Indifference Curve Interpretation for the Time Trade-off Technique," Centre for Health Economics and Policy Analysis Working Paper Series 13, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    7. Magnus Johannesson & Joseph S. Pliskin & Milton C. Weinstein, 1994. "A Note on QALYs, Time Tradeoff, and Discounting," Medical Decision Making, , vol. 14(2), pages 188-193, April.
    8. Bleichrodt, Han & Gafni, Amiram, 1996. "Time preference, the discounted utility model and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 49-66, February.
    9. Bleichrodt, Han & Johannesson, Magnus, 1997. "Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs," Journal of Health Economics, Elsevier, vol. 16(2), pages 155-175, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    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. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.
    3. Arthur E. Attema & Matthijs M. Versteegh, 2013. "Would You Rather Be Ill Now, Or Later?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1496-1506, December.
    4. José‐María Abellán‐Perpiñán & José‐Luis Pinto‐Prades & Ildefonso Méndez‐Martínez & Xabier Badía‐Llach, 2006. "Towards a better QALY model," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 665-676, July.
    5. José Mª Abellán & José Luis Pinto & Ildefonso Méndez & Xabier Badía, 2004. "A test of the predictive validity of non-linear QALY models using time trade-off utilities," Economics Working Papers 741, Department of Economics and Business, Universitat Pompeu Fabra.
    6. 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.
    7. Marjon Pol & Larissa Roux, 2005. "Time preference bias in time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 107-111, June.

    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. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.
    2. José‐María Abellán‐Perpiñán & José‐Luis Pinto‐Prades & Ildefonso Méndez‐Martínez & Xabier Badía‐Llach, 2006. "Towards a better QALY model," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 665-676, July.
    3. Marjon Pol & Larissa Roux, 2005. "Time preference bias in time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 107-111, June.
    4. repec:ebl:ecbull:v:9:y:2005:i:7:p:1-8 is not listed on IDEAS
    5. José Mª Abellán & José Luis Pinto & Ildefonso Méndez & Xabier Badía, 2004. "A test of the predictive validity of non-linear QALY models using time trade-off utilities," Economics Working Papers 741, Department of Economics and Business, Universitat Pompeu Fabra.
    6. Juan D. Moreno-Ternero & Carmen Herrero, 2005. "A new outcome measure for cost-utility analyses of screening programs," Economics Bulletin, AccessEcon, vol. 9(7), pages 1-8.
    7. 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.
    8. Ried, Walter, 1998. "QALYs versus HYEs--what's right and what's wrong. A review of the controversy," Journal of Health Economics, Elsevier, vol. 17(5), pages 607-625, October.
    9. 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.
    10. Paul F M Krabbe, 2013. "A Generalized Measurement Model to Quantify Health: The Multi-Attribute Preference Response Model," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-12, November.
    11. 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.
    12. Bleichrodt, Han & Pinto, Jose Luis & Maria Abellan-Perpinan, Jose, 2003. "A consistency test of the time trade-off," Journal of Health Economics, Elsevier, vol. 22(6), pages 1037-1052, November.
    13. Hans-Helmut König & Oliver Günther & Matthias Angermeyer & Christiane Roick, 2009. "Utility Assessment in Patients with Mental Disorders," PharmacoEconomics, Springer, vol. 27(5), pages 405-419, May.
    14. Somayeh Sadat & Michael Carter & Brian Golden, 2013. "Theory of constraints for publicly funded health systems," Health Care Management Science, Springer, vol. 16(1), pages 62-74, March.
    15. Buckingham, Ken J. & Devlin, Nancy Joy, 2009. "A note on the nature of utility in time and health and implications for cost utility analysis," Social Science & Medicine, Elsevier, vol. 68(2), pages 362-367, January.
    16. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.
    17. Benjamin M. Craig, 2009. "The duration effect: a link between TTO and VAS values," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 217-225, February.
    18. Joshua A. Salomon & Christopher J.L. Murray, 2004. "A multi‐method approach to measuring health‐state valuations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 281-290, March.
    19. Irvine, Alastair & van der Pol, Marjon & Phimister, Euan, 2019. "A comparison of professional and private time preferences of General Practitioners," Social Science & Medicine, Elsevier, vol. 222(C), pages 256-264.
    20. Bleichrodt, Han & Johannesson, Magnus, 1997. "Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs," Journal of Health Economics, Elsevier, vol. 16(2), pages 155-175, April.
    21. K. Stavem & I. S. Kristiansen & J. A. Olsen, 2002. "Association of time preference for health with age and disease severity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(2), pages 120-124, June.

    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:wly:hlthec:v:12:y:2003:i:2:p:165-169. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.