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Evaluating the consequences of rheumatoid arthritis

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Abstract

Patients and non-patients tend to attach different utility values to the state of suffering from specific illnesses. This observation naturally leads to the question whose utility values should be used as the basis in cost-effectiveness analysis (CEA). Intuitively, one would presume that patients are better informed about the consequences of their illness, and public authorities should, therefore, use the patients’ utility values in CEA. Contrary to this presumption, it has been argued that society at large should determine which values are to be used and not the patients because, in the end, it is societal resources that are to be allocated. Against this background, we use data from a discrete choice experiment (DCE) that was completed by patients of rheumatoid arthritis (RA) and non-patients to explore the discrepancies between the two groups' utility estimates for typical consequences of RA. Our results indicate that both groups attach remarkably similar part-worth utilities to the symptoms pain, fatigue, and functional limitations. However, non-patients significantly undervalue the ability to work when compared to patients.

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Notes

  1. Note that this is a rather conservative estimation. Fuchs et al. [13] report an estimated prevalence of lifetime RA of 2.5 % of all 18–79-year-olds in Germany.

  2. Note that we employ a generic DCE. That means that the alternatives in our choice sets are not labeled, at least not in a meaningful way.

  3. We include the lower bounds of the income categories in the regression. The results are, however, robust with regard to significance when alternatively including the category means or the upper bounds and excluding responses from the highest and boundless income category.

  4. We include the category “3 or more persons” as 3 in the regression analysis.

  5. Note that a positive sign means that the according level increases choice probability and the respondents were asked to choose the worse of the two alternatives in every choice set.

  6. Note that this calculation is critically dependent on our assumption regarding the structure of the indirect utility function \(V_{in}\) and our assumption about the absence of significant interaction effects among the mentioned attributes.

  7. Note that one could of course also analyze the discrepancies between patients and non-patients with regard to the valuation of disease symptoms or consequences by employing TTO and SG.

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Acknowledgments

We gratefully acknowledge financial support from AbbVie Deutschland GmbH & Co. KG. Malte Wolff is an employee of AbbVie and holds AbbVie stock. In addition, we thank Thomas Kohlmann, Jens Kuipers, Wilfried Mau, Sonja Merkesdal, Elmar Schmitz-Bortz, Oliver Schöffski, Florian Schuch, and Jürgen Währisch for supporting this project.

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Authors and Affiliations

  1. Ruhr Graduate School in Economics and University of Duisburg-Essen, Dorothea-Bernstein-Weg 13, 22081, Hamburg, Germany

    Björn Sossong

  2. University of Basel, Basel, Switzerland

    Stefan Felder

  3. AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany

    Malte Wolff

  4. LMU Munich and Rheumazentrum München, Munich, Germany

    Klaus Krüger

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  1. Björn Sossong
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  2. Stefan Felder
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Correspondence to Björn Sossong.

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Sossong, B., Felder, S., Wolff, M. et al. Evaluating the consequences of rheumatoid arthritis. Eur J Health Econ 18, 685–696 (2017). https://doi.org/10.1007/s10198-016-0818-x

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  • DOI: https://doi.org/10.1007/s10198-016-0818-x

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