Deriving Time Discounting Correction Factors for Tto Tariffs

Attema, Arthur E.; Brouwer, Werner

doi:10.1002/hec.2921

Cited by 8 publications

(8 citation statements)

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“…First, it is the first applying a corrective approach with interviewer-assisted data collection with members of the general public. Some authors have explored correction for discounting in cTTO in the general public using online self-completed data collection (Attema & Brouwer, 2014), but this mode of administration will generally lead to lower quality data and increased no-shows (Norman et al, 2010). Furthermore, our results may be of larger practical relevance, as cTTO utilities were obtained following the EQ-VT protocol.…”

Section: Discussionmentioning

confidence: 97%

“…This model assumes utility of life duration is linear, that is, future life years are not discounted. In practice, this assumption is violated for many individuals, who positively discount the future, which means they derive less utility from health in the future (Attema & Brouwer, 2014;Attema et al, 2012;Van Der Pol & Roux, 2005). On the other hand, negative discounting has been observed as well, that is, individuals assigning more weight to health in the future (e.g., Lipman & Attema, 2020;Van Der Pol & Cairns, 2000).…”

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confidence: 99%

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Correcting for discounting and loss aversion in composite time trade‐off

2022

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Time trade‐off utilities have been suggested to be biased upwards. This bias is a result of the method being applied assuming linear utility of life duration, which is violated when individuals discount future life years or are loss averse for health. Applying a “corrective approach”, that is, measuring individuals' discount function and loss aversion and correcting time trade‐off utilities for these individual characteristics, may reduce this bias in utilities. Earlier work has developed this approach for time trade‐off in a student sample. In this study, the corrective approach was extended to composite time trade‐off (cTTO) methodology, which enabled correcting utilities for health states worse than dead. In digital interviews a sample of 150 members of the general public completed cTTO tasks for six health states, and afterward they completed measurements of loss aversion and discounting. cTTO utilities were corrected using these measurements under multiple specifications. Respondents were also asked to reflect on and adjust their cTTO utilities directly. Our results show considerable loss aversion and both positive and negative discounting were prevalent. As predicted, correction generally resulted in lower utilities. This was in accordance with the direction of adjustments made by respondents themselves.

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Section: Discussionmentioning

confidence: 97%

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confidence: 99%

Correcting for discounting and loss aversion in composite time trade‐off

2022

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“…The influence of time discounting on cTTO values was not regarded in this experimental study as the focus was on testing the EQ-VT 1.1 and the further three modifications. Thereby, a possibly resulting downward bias cannot be excluded [ 15 , 25 ]. More exploratory research is required to develop ways of controlling for time preferences in the estimation of cTTO tariffs.…”

Section: Discussionmentioning

confidence: 99%

“…More exploratory research is required to develop ways of controlling for time preferences in the estimation of cTTO tariffs. Thereby different discount rate elicitation procedures should be developed and their feasibility as well as their validity in general population samples should be explored [ 15 , 16 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Valuation of the EQ-5D-5L with composite time trade-off for the German population – an exploratory study

Ludwig

Schulenburg

Greiner

2017

Health Qual Life Outcomes

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BackgroundThe EuroQol Group has extended the severity levels of the EQ-5D from three to five (EQ-5D-5L). There are valuation studies worldwide planned in order to convert the EQ-5D-5L health states into a single preference-based summary score based on country-specific value sets of social health status preference valuations. The EuroQol Group developed an internationally standardised EQ-5D-5L valuation protocol. Based on the experiences of the first wave of valuation studies applying the protocol, a number of modifications to the implementation of composite time trade-off (cTTO) were proposed and tested in an exploratory study in Germany.MethodsThe aim of the study is to test the improved EQ-5D-5L valuation protocol 1.1 and the implementation of three modifications: (1) introduction of ranking task, (2) separating time trade-off (TTO) tasks for health states “Better Than Dead“(BTD)/“Worse Than Dead” (WTD), (3) allow for removal of problematic valuations from the cTTO data (the feedback module). Data were collected in computer assisted personal interviews with 200 members of the German general public.ResultsIn comparison to the first wave of valuation studies a higher data quality can be observed in both study arms: increasing number of WTD valuations, reduced inconsistencies for health state 55555 as well as higher values for mild health states. Comparing both study arms, mean observed cTTO value for severity 6 is higher in the test arm. The proportion of inconsistent cTTO responses is lower in the test arm than in the control arm and is further reduced by the feedback module. The ranking task prolongs the interview without the desired effect.ConclusionsBoth study arms yielded higher data quality in comparison to the first wave of EQ-5D-5L valuation studies. The valuation protocol combined with an intensive interviewer training and close data monitoring showed a high feasibility and acceptability to the respondents of the general population as well as the interviewers in Germany. Based on the results of this study and other countries, the separation of TTO tasks for health states BTD/WTD and the feedback module will be implemented in the valuation study for the EQ-5D-5L for Germany.

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“…Respondents tend to value years further in the future lower than more immediate ones, which could lead them to give up future life years in exchange for utility gains relatively easily. This would result in biased utility estimates, since all years are equally valuable in the QALY concept [2]. To correct this bias, the indifference points from the TTO as well as the normal life expectancy were discounted by the 1.5% per year rate that is prescribed for future health benefits by the Dutch health economic guidelines [21].…”

Section: Methodsmentioning

confidence: 99%

Health state utilities for infertility and subfertility

Krol¹,

Nap

Michels³

et al. 2019

Reprod Health

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Background Health state utility values allow for comparison of treatments across different diseases. Utility values for fertility-impaired health states are currently unavailable. Such values are necessary in order to determine the relative costs-effectiveness of fertility treatments. Methods This study aimed to determine utility weights for infertile and subfertile health states. In addition, it explored the Dutch general population’s opinions regarding the inclusion of infertility treatments in the Dutch health insurers’ basic benefit package. An online questionnaire was designed to determine the health-related quality of life values of six fertility-impaired health states. The study population consisted of a representative sample of the Dutch adult population. Respondents were asked to evaluate the health states through direct health valuation methods, i.e. the Visual Analogue Scale (VAS) and the Time Trade-Off (TTO) method. In addition, respondents were asked about their opinions regarding reimbursement of fertility-related treatments. Results The respondents’ ( n = 767) VAS scores ranged from 0.640 to 0.796. TTO utility values ranged from 0.792 to 0.868. Primary infertility and subfertility was valued lower than secondary infertility and subfertility. In total, 92% of the respondents stated that fertility treatments should be fully or partially reimbursed by the health insurance basic benefit package. Conclusions Having fertility problems results in substantial disutilities according to the viewpoint of the Dutch general population. The results make it possible to compare the value for money of infertility treatment to that of treatments in other disease areas. There is strong support among the general population for reimbursing fertility treatments through the Dutch basic benefit package.

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Deriving Time Discounting Correction Factors for Tto Tariffs

Cited by 8 publications

References 69 publications

Correcting for discounting and loss aversion in composite time trade‐off

Correcting for discounting and loss aversion in composite time trade‐off

Valuation of the EQ-5D-5L with composite time trade-off for the German population – an exploratory study

Health state utilities for infertility and subfertility

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