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Efficiency And Equity: A Stated Preference Approach

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  • Richard Norman
  • Jane Hall
  • Deborah Street
  • Rosalie Viney

Abstract

Outcome measurement in the economic evaluation of health care considers outcomes independent of to whom they accrue. This article reports on a discrete choice experiment designed to elicit population preferences regarding the allocation of health gain between hypothetical groups of potential patients. A random‐effects probit model is estimated, and a technique for converting these results into equity weights for use in economic evaluation is adopted. On average, the modelling predicts a relatively high social value on health gains accruing to nonsmokers, carers, those with a low income and those with an expected age of death less than 45 years. Respondents tend to favour individuals with similar characteristics to themselves. These results challenge the conventional practice of assuming constant equity weighting. For decision makers, whether a formal equity weighting system represents an improvement on more informal approaches to weighing up equity and efficiency concerns remains uncertain. Copyright © 2012 John Wiley & Sons, Ltd.

Suggested Citation

  • Richard Norman & Jane Hall & Deborah Street & Rosalie Viney, 2013. "Efficiency And Equity: A Stated Preference Approach," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 568-581, May.
    • Handle: RePEc:wly:hlthec:v:22:y:2013:i:5:p:568-581
    DOI: 10.1002/hec.2827
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    References listed on IDEAS

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    1. Lancsar, Emily & Gu, Yuanyuan & Gyrd-Hansen, Dorte & Butler, Jim & Ratcliffe, Julie & Bulfone, Liliana & Donaldson, Cam, 2020. "The relative value of different QALY types," Journal of Health Economics, Elsevier, vol. 70(C).
    2. Whitty, Jennifer A. & Littlejohns, Peter, 2015. "Social values and health priority setting in Australia: An analysis applied to the context of health technology assessment," Health Policy, Elsevier, vol. 119(2), pages 127-136.
    3. Anita Lal & Mohammad Siahpush & Marjory Moodie & Anna Peeters & Robert Carter, 2018. "Weighting Health Outcomes by Socioeconomic Position Using Stated Preferences," PharmacoEconomics - Open, Springer, vol. 2(1), pages 43-51, March.
    4. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    5. E. Wetering & N. Exel & J. Rose & R. Hoefman & W. Brouwer, 2016. "Are some QALYs more equal than others?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 117-127, March.
    6. Shehzad Ali & Aki Tsuchiya & Miqdad Asaria & Richard Cookson, 2017. "How Robust Are Value Judgments of Health Inequality Aversion? Testing for Framing and Cognitive Effects," Medical Decision Making, , vol. 37(6), pages 635-646, August.
    7. Chris Skedgel & Allan Wailoo & Ron Akehurst, 2015. "Societal Preferences for Distributive Justice in the Allocation of Health Care Resources," Medical Decision Making, , vol. 35(1), pages 94-105, January.
    8. Edward Henry & John Cullinan, 2024. "Addressing the distributional consequences of spillovers in health economic evaluation: A prioritarian approach," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 764-778, April.
    9. Jennifer Whitty & Emily Lancsar & Kylie Rixon & Xanthe Golenko & Julie Ratcliffe, 2014. "A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(4), pages 365-386, December.
    10. Jennifer A Whitty & Ruth Walker & Xanthe Golenko & Julie Ratcliffe, 2014. "A Think Aloud Study Comparing the Validity and Acceptability of Discrete Choice and Best Worst Scaling Methods," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    11. Gemma Lasseter & Hareth Al-Janabi & Caroline L Trotter & Fran E Carroll & Hannah Christensen, 2018. "The views of the general public on prioritising vaccination programmes against childhood diseases: A qualitative study," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-18, June.
    12. LUYTEN, Jeroen & KESSELS, Roselinde & GOOS, Peter & BEUTELS, Philippe, 2013. "Public preferences for prioritizing preventive and curative health care interventions: A discrete choice experiment," Working Papers 2013032, University of Antwerp, Faculty of Business and Economics.
    13. Liesbet Wetering & Job Exel & Ana Bobinac & Werner Brouwer, 2015. "Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 33(12), pages 1289-1300, December.
    14. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    15. Stuart J. Wright & Mike Paulden & Katherine Payne, 2020. "Implementing Interventions with Varying Marginal Cost-Effectiveness: An Application in Precision Medicine," Medical Decision Making, , vol. 40(7), pages 924-938, October.
    16. Simon McNamara & John Holmes & Abigail K. Stevely & Aki Tsuchiya, 2020. "How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 275-285, March.

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