OBJECTIVES: Whose preferences to use in economic evaluation has long been debated within health economics. Health technology assessment (HTA) agencies differ in their approaches. For instance the TLV in Sweden, prefer utility values to come directly from patients whereas NICE in the UK, prefer values from the general population. This is essentially a normative judgement, but do these values differ? The aim of this study is to compare utility values elicited from the two samples of UK respondents: a general population sample and a sample of patients with Crohn’s disease (CD).

METHODS: Eight health state vignettes associated with complex perianal fistulae in CD were developed and refined from interviews with patients and these were validated by clinicians. An on-line time trade off (TTO) was used to elicit preferences. In addition to valuing the hypothetical vignettes, patients with CD were asked to value their own current health state.

RESULTS: In total 835 respondents were included in the general population study of the and were reflective of the UK population in age and gender. In the patient study, 162 patients with CD were included. Non-remission states were valued much lower than the remission state by both samples: ranging from 0.20 for proctectomy with negative outcome to 0.66 for chronic symptomatic fistulae with mild symptoms. Patients reported slightly higher values than the general population for most health states. The relative difference in mean values was greatest for the most severe health states. This is consistent with our finding from the subgroup analysis of the general population sample in which respondents with experience (self, family or friend has CD) provided higher estimates than those without any experience of CD.

CONCLUSIONS: Patients reported slightly higher values than the general population for most health states; the difference was greatest for the most severe health states.