The Corrective Approach: Policy Implications of Recent Developments in QALY Measurement Based on Prospect Theory

Jul 1, 2019, 00:00
10.1016/j.jval.2019.01.013
https://www.valueinhealthjournal.com/article/S1098-3015(19)30076-2/fulltext
Title : The Corrective Approach: Policy Implications of Recent Developments in QALY Measurement Based on Prospect Theory
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(19)30076-2&doi=10.1016/j.jval.2019.01.013
First page : 816
Section Title : METHODOLOGY
Open access? : Yes
Section Order : 816

Background and Objectives

Common health state valuation methodology, such as time tradeoff (TTO) and standard gamble (SG), is typically applied under several descriptively invalid assumptions, for example, related to linear quality-adjusted life years (QALYs) or expected utility (EU) theory. Hence, the current use of results from health state valuation exercises may lead to biased QALY weights, which may in turn affect decisions based on economic evaluations using such weights. Methods have been proposed to correct responses for the biases associated with different health state valuation techniques. In this article we outline the relevance of prospect theory (PT), which has become the dominant descriptive alternative to EU, for health state valuations and economic evaluations.

Methods and Results

We provide an overview of work in this field, which aims to remove biases from QALY weights. We label this “the corrective approach.” By quantifying PT parameters, such as loss aversion, probability weighting, and nonlinear utility, it may be possible to correct TTO and SG responses for biases in an attempt to produce more valid estimates of preferences for health states. Through straightforward examples, this article illustrates the effects of this corrective approach and discusses several unresolved issues that currently limit the relevance of corrected weights for policy.

Conclusions

Suggestions for research addressing these issues are provided. Nonetheless, if validly corrected health state valuations become available, we argue in favor of using these in economic evaluations.

Categories :
  • Health State Utilities
  • Patient-reported Outcomes & Quality of Life Outcomes
  • PRO & Related Methods
Tags :
  • corrective approach
  • loss aversion
  • prospect theory
  • QALYs
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