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Does the whole equal the sum of the parts? Patient‐assigned utility scores for IBS‐related health states and profiles

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  • John Brazier
  • Paul Dolan
  • Korina Karampela
  • Isabel Towers

Abstract

The quality‐adjusted life year (QALY) assumes that the value of a health state is linearly related to the time spent in it, which implies that the value of a health state is independent of the states which precede or follow it. Irritable bowel syndrome (IBS) is a suitable condition to test this assumption since it is subject to considerable fluctuations over time. Forty‐nine IBS patients were asked to rate their own health using generic measures of health and a condition specific classification. They were then asked to value five IBS states and four profiles using a self‐completed version of the standard gamble technique. The implied value of each profile was estimated using the QALY assumption of linearity over time and compared with the direct profile valuations. The directly elicited profile values suggest that reductions in the duration of IBS symptoms has less of an impact on the value of quality of life than would be implied by the QALY assumption of linearity over time, though the differences were small. There are a number of competing explanations for this finding, including possible sequence effects, quantity effects or time preference, or it might be due to gestalt effects resulting in a neglect of time spent in symptomatic states of health. Copyright © 2005 John Wiley & Sons, Ltd.

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  • John Brazier & Paul Dolan & Korina Karampela & Isabel Towers, 2006. "Does the whole equal the sum of the parts? Patient‐assigned utility scores for IBS‐related health states and profiles," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 543-551, June.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:6:p:543-551
    DOI: 10.1002/hec.1074
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    1. Peter P. Wakker, 2008. "Explaining the characteristics of the power (CRRA) utility family," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1329-1344, December.
    2. Bleichrodt, Han & Filko, Martin, 2008. "New tests of QALYs when health varies over time," Journal of Health Economics, Elsevier, vol. 27(5), pages 1237-1249, September.
    3. Peter P. Wakker, 2008. "Explaining the characteristics of the power (CRRA) utility family," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1329-1344.
    4. Koonal K. Shah & Bryan Bennett & Andrew Lenny & Louise Longworth & John E. Brazier & Mark Oppe & A. Simon Pickard & James W. Shaw, 2021. "Adapting preference-based utility measures to capture the impact of cancer treatment-related symptoms," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1301-1309, November.
    5. Leyla Mohseninejad & Talitha Feenstra & Henriëtte Horst & Hèlen Woutersen-Koch & Erik Buskens, 2013. "Targeted screening for Coeliac Disease among irritable bowel syndrome patients: analysis of cost-effectiveness and value of information," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 947-957, December.
    6. Edward J. D. Webb & John O’Dwyer & David Meads & Paul Kind & Penny Wright, 2020. "Transforming discrete choice experiment latent scale values for EQ-5D-3L using the visual analogue scale," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 787-800, July.

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