What Is the Relative VALUE of Carer and Patient Quality of Life? a Person Trade-Off (PTO) Study with the UK Public
Author(s)
Al-Janabi H*1;Wittenberg E2;Donaldson C3, Brouwer W4
1University of Birmingham, Birmingham, UK, 2Harvard School of Public Health, Boston, MA, USA, 3Glasgow Caledonian University, Glasgow, UK, 4Erasmus School of Health Policy & Management, Rotterdam, Netherlands
OBJECTIVES: Carer quality of life is increasingly incorporated in economic evaluations; a practice now advocated in methods guidelines. The objective of this study was to establish the relative value placed on carer and patient quality of life by society for use in economic evaluation.
METHODS: A person trade-off study was designed to elicit preferences for carer and patient quality of life. 990 representative members of the UK public chose between hypothetical services that improved the quality of life of carers and patients, iterating to a point of indifference. Alternative scenarios investigated the effect of the scope and starting point of quality of life gains, as well as the effect of patient age and whether the service benefitted both carers and patients. Data were collected on the reasons for choices and social attitudes to priority setting.
RESULTS: The majority (84%) of respondents were willing to forego some patient quality of life improvements to improve carer quality of life. Aggregation of preferences, via ratio of means, generated a ‘social weighting’ of 0.74 for carer health-related quality of life effects and 0.69 for carer care-related quality of life effects.
CONCLUSIONS: This study provides (i) evidence that public preferences support the inclusion of carer effects within economic evaluation; (ii) a means to weight carer quality of life in economic evaluation according to social value; and (iii) a methodology that could be adapted to examine the relative value of carer and patient quality of life in specific contexts.
METHODS: A person trade-off study was designed to elicit preferences for carer and patient quality of life. 990 representative members of the UK public chose between hypothetical services that improved the quality of life of carers and patients, iterating to a point of indifference. Alternative scenarios investigated the effect of the scope and starting point of quality of life gains, as well as the effect of patient age and whether the service benefitted both carers and patients. Data were collected on the reasons for choices and social attitudes to priority setting.
RESULTS: The majority (84%) of respondents were willing to forego some patient quality of life improvements to improve carer quality of life. Aggregation of preferences, via ratio of means, generated a ‘social weighting’ of 0.74 for carer health-related quality of life effects and 0.69 for carer care-related quality of life effects.
CONCLUSIONS: This study provides (i) evidence that public preferences support the inclusion of carer effects within economic evaluation; (ii) a means to weight carer quality of life in economic evaluation according to social value; and (iii) a methodology that could be adapted to examine the relative value of carer and patient quality of life in specific contexts.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
SP2
Topic
Economic Evaluation, Health Policy & Regulatory, Patient-Centered Research
Topic Subcategory
Health Disparities & Equity, Health State Utilities, Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Multiple Diseases, No Specific Disease