Do quality-adjusted life years take account of lost income? Evidence from an Australian survey

  • Jeff Richardson
  • Stuart J. Peacock
  • Angelo Iezzi
Original paper

Abstract

The procedures used in cost utility analysis for eliciting quality of life weights have generally omitted any instruction concerning the level of consumption in a health state, despite the fact that some health states preclude the possibility of normal employment. This introduces ambiguity into the interpretation of quality of life (QoL) scores, and project ranking is sensitive to the subsequent treatment of consumption in the analysis. This article reports the results of a study that questioned 131 respondents to a time trade-off (TTO) interview about their assumptions concerning consumption and the amount of thought given to consumption. Results indicate that, without prompting, most assumed unchanged consumption, implying little bias in existing studies.

Keywords

Cost utility analysis Outcomes Quality-adjusted life years Indirect benefits Consumption benefits 

JEL Classification

I10 I18 I19 

Notes

Acknowledgements

Stuart Peacock is a scholar of the Michael Smith Foundation for Health Research. The views expressed in this paper are solely those of the authors.

References

  1. 1.
    Brouwer, W.B., Koopmanschap, M.A.: On the economic foundations of CEA. Ladies and gentlemen, take your positions! J. Health Econ. 19, 439–459 (2000)CrossRefGoogle Scholar
  2. 2.
    Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity costs means through quality of life? A response to the recommendation of the Washington Panel. Health Econ. 6, 253–259 (1997)CrossRefGoogle Scholar
  3. 3.
    Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Econ. 6, 511–514 (1997)CrossRefGoogle Scholar
  4. 4.
    Brouwer, W.B., Rutten, F.F.: The missing link: on the line between C and E. Econ. Eval. 12, 629–636 (2003)Google Scholar
  5. 5.
    Dowie, J.A.: Valuing the benefits of health improvement. Aust. Econ. Pap. 9(14), 21–41 (1970)CrossRefGoogle Scholar
  6. 6.
    Gold M.R., Siegel J.E., Russell L.B., Weinstein M.C.: Cost effectiveness in health and medicine. Oxford University Press, Oxford (1996)Google Scholar
  7. 7.
    Hawthorne, G., Richardson J, Day, N.A.: A comparison of the assessment of quality of life (AQoL) with four other generic utility instruments. Ann. Med. 33(5), 358–370 (2001)CrossRefGoogle Scholar
  8. 8.
    Johannesson M.: Avoiding double counting in pharmacoeconomic studies. Pharmacoeconomics 11, 385–388 (1997)CrossRefGoogle Scholar
  9. 9.
    Johannesson, M., Karlsson, G.: The friction cost method: a comment. J. Health Econ. 16, 249–256 (1997)CrossRefGoogle Scholar
  10. 10.
    Koopmanschap, M., Rutten, F.F., van Ineveld, B.M., van Roijen L.: The friction cost method for measuring indirect costs of disease. J. Health Econ. 14, 171–189 (1995)CrossRefGoogle Scholar
  11. 11.
    Krol, M., Brouwer, W., Sendi P.: Productivity cost in health state valuations: does explicit instruction matter. Pharmacoeconomics 24(4), 401 (2006)CrossRefGoogle Scholar
  12. 12.
    Meltzer, D., Weckerle C., Chang, L.M.: Do people consider financial effects in answering quality of life questions. Med. Decis. Making 19, 517 (1999)CrossRefGoogle Scholar
  13. 13.
    Misajon, R., Hawthorne, G., Richardson, J., Barton, J., Peacock, S., Iezzi A., Keeffe J: Vision and Quality of Life: The Development of a Utility Measure. Invest. Ophthalmol. Vis. Sci. 46, 4007–4015 (2005)Google Scholar
  14. 14.
    Myers, J., McCabe, S., Gohmann S: Quality-of-life-assessment when there is a loss of income. Med. Decis. Making, 27, 27–33 (2007)Google Scholar
  15. 15.
    Olsen, J.A., Richardson J.: Production gains from health care: what should be included in cost-effectiveness analyses? Soc. Sci. Med. 49, 17–26 (1999)CrossRefGoogle Scholar
  16. 16.
    Peacock, S., Misajon, R., Iezzi, A., Richardson, J., Hawthorne, G., Keeffe J.: Vision and quality of life: development of methods for the VisQoL vision related utility instrument. Ophthalmic Epidemiol. (2008, in press)Google Scholar
  17. 17.
    Richardson, J.: Economic assessment of health care: theory in practice. Aust. Econ. Rev. 1, 4–21 (1991)CrossRefGoogle Scholar
  18. 18.
    Richardson, J., Day, N.A., Peacock, S., Iezzi, A.: Measurement of quality of life for economic evaluation and the assessment of quality of life (AQoL) mark II instrument. Aust. Econ. Rev. 37, 62–88 (2004)CrossRefGoogle Scholar
  19. 19.
    Sendi, P., Brouwer, W.B.F.: Is silence golden? A test of the incorporation of the effects of ill-health on income and leisure in health state valuations. Health Econ. 14, 643–647 (2005)CrossRefGoogle Scholar
  20. 20.
    Weinstein, M.C., Siegel, J.E., et al.: Productivity costs, time costs and health related quality of life: a response to the Erasmus group. Health Econ. 6, 505–510 (1997)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Jeff Richardson
    • 1
  • Stuart J. Peacock
    • 1
    • 2
    • 3
  • Angelo Iezzi
    • 1
  1. 1.Centre for Health EconomicsMonash UniversityMelbourneAustralia
  2. 2.Centre for Health Economics in CancerBritish Columbia Cancer AgencyVancouverCanada
  3. 3.Department of Health Care and EpidemiologyUniversity of British ColumbiaVancouverCanada

Personalised recommendations