OBJECTIVES: To understand factors impacting the time people are willing to sacrifice to restore a non-healthy family member to full health in a new Time Trade Off (TTO) method for estimating non-patient utilities.

METHODS: Semi-structured interviews lasting 45 minutes were conducted with 10 participants based in the United Kingdom. Draft TTO exercises describing hypothetical family members (child/partner/parent/grandparent) in moderately and severely poor health states (HS) were presented to participants. Cognitive interviewing was used to confirm participants’ understanding of each exercise and to identify factors influencing how many years of their own remaining life expectancy they’d be willing to sacrifice to restore each relative’s health in each exercise. Thematic analysis was used to identify themes in factors impacting participant responses.

RESULTS: Participants (N=10) were male (n=6) or female (n=4). Most did not currently live with a non-healthy family member (n=7). The largest sacrifices (average: 83% of remaining life expectancy) were to restore a child to full health from a severe HS, and the smallest sacrifices (average: 8% of remaining life expectancy) were to restore a grandparent to full health from a moderate HS. Factors impacting the sacrifices made were organized into drivers (n=17; factors increasing number of years sacrificed) and barriers (n=18; factors decreasing number of years sacrificed). Key drivers were altruism (including improving relatives’ quality of life; n=10), benefits for self (including avoiding providing care for a relative; n=7), and the mutual benefit of having quality remaining time together (n=9). The relative’s age, the quality of the relationship with the relative, and one’s own goals and ambitions were both drivers and barriers depending on the context.

CONCLUSIONS: Many factors influence the sacrifices one might make to restore a relative’s health. The strong influence of altruism may need to be corrected for to use this TTO approach to elicit non-patient utilities.