Advertisement

PharmacoEconomics

, Volume 33, Issue 8, pp 849–855 | Cite as

Choice of Outcome Measure in an Economic Evaluation: A Potential Role for the Capability Approach

  • Paula K. LorgellyEmail author
Practical Application

Abstract

The last decade has seen a renewed interest in Sen’s capability approach; health economists have been instrumental in leading much of this work. One particular stream of research is the application of the approach to outcome measurement. To date, there have been a dozen attempts (some combined) to operationalise the approach, and produce an outcome measure that offers a broader evaluative space than health-related quality-of-life measures. Applications have so far been confined to public health, physical, mental health and social care interventions, but the capability approach could be of benefit to evaluations of pharmacotherapies and other technologies. This paper provides an introduction to the capability approach, reviews the measures that are available for use in an economic evaluation, including their current applications, and then concludes with a discussion of a number of issues that require further consideration before the approach is adopted more widely to inform resource allocation decisions.

Keywords

Health Technology Assessment Social Care Aflibercept Capability Approach Lisdexamfetamine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The author would like to acknowledge the ICECAP team, particularly Prof. Joanna Coast and Dr Philip Kinghorn, for providing an anonymised registry of trials and studies that are using the ICECAP instruments. The author has no conflicts of interest.

References

  1. 1.
    Stoddart A, Hanley J, Wild S, Pagliari C, Paterson M, Lewis S, Sheikh A, Krishan A, Padfield P, McKinstry B. Telemonitoring-based service redesign for the management of uncontrolled hypertension (HITS): cost and cost-effectiveness analysis of a randomised controlled trial. BMJ Open. 2013; 3(5).Google Scholar
  2. 2.
    Pizzi LT, Seligman NS, Baxter JK, Jutkowitz E, Berghella V. Cost and cost effectiveness of vaginal progesterone gel in reducing preterm birth: an economic analysis of the PREGNANT trial. PharmacoEconomics. 2014;32(5):467–78.PubMedCrossRefGoogle Scholar
  3. 3.
    Khor S, Beca J, Krahn M, Hodgson D, Lee L, Crump M, Bremner KE, Luo J, Mamdani M, Bell CM. Real world costs and cost-effectiveness of rituximab for diffuse large B-cell lymphoma patients: a population-based analysis. BMC Cancer. 2014;14(1):586.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Wisløff T, Hagen G, Hamidi V, Movik E, Klemp M, Olsen JA. Estimating QALY gains in applied studies: a review of cost-utility analyses published in 2010. PharmacoEconomics. 2014;32(4):367–75.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Neumann PJ, Greenberg D, Olchanski NV, Stone PW, Rosen AB. Growth and quality of the cost-utility literature, 1976–2001. Value Health. 2005;8(1):3–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Robinson R. Cost-effectiveness analysis. BMJ. 1993;307(6907):793.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Lorgelly PK, Lawson KD, Fenwick EA, Briggs AH. Outcome measurement in economic evaluations of public health interventions: a role for the capability approach? Int J Environ Res Public Health. 2010;7(5):2274–89.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Coast J. Is economic evaluation in touch with society’s health values? BMJ. 2004;329(7476):1233.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Shiell A, Hawe P, Gold L. Complex interventions or complex systems? Implications for health economic evaluation. BMJ. 2008;336(7656):1281–3.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Payne K, McAllister M, Davies LM. Valuing the economic benefits of complex interventions: when maximising health is not sufficient. Health Econ. 2013;22(3):258–71.PubMedCrossRefGoogle Scholar
  11. 11.
    Sen A. Commodities and capabilities. New York: Elsevier; 1985.Google Scholar
  12. 12.
    Sen A. Capability and well-being. In: Sen A, Nussbaum MC, editors. The quality of life. Oxford: Claredon Press; 1993.Google Scholar
  13. 13.
    Coast J, Smith R, Lorgelly P. Should the capability approach be applied in health economics? Health Econ. 2008;17(6):667–70.PubMedCrossRefGoogle Scholar
  14. 14.
    Coast J, Smith RD, Lorgelly P. Welfarism, extra-welfarism and capability: The spread of ideas in health economics. Soc Sci Med. 2008;67(7):1190–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Kahneman D, Wakker PP, Sarin R. Back to bentham? Explorations of experienced utility. Q J Econ. 1997;112(2):375–405.CrossRefGoogle Scholar
  16. 16.
    Di Tella R, MacCulloch R. Some uses of happiness data in economics. J Econ Perspect. 2006;20(1):25–46.CrossRefGoogle Scholar
  17. 17.
    Dolan P, Peasgood T, White M. Do we really know what makes us happy? A review of the economic literature on the factors associated with subjective well-being. J Econ Psychol. 2008;29(1):94–122.CrossRefGoogle Scholar
  18. 18.
    Burchardt T. Agency goals, adaptation and capability sets. J Hum Dev Capab. 2009;10(1):3–19.CrossRefGoogle Scholar
  19. 19.
    Sugden R. Welfare, resources, and capabilities: a review of inequality reexamined by Amartya Sen. J Econ Lit. 1993;31(4):1947–62.Google Scholar
  20. 20.
    Culyer AJ. The normative economics of health care finance and provision. Oxf Rev Econ Policy. 1989;5(1):34–56.CrossRefGoogle Scholar
  21. 21.
    Coast J, Kinghorn P, Mitchell P. The development of capability measures in health economics: opportunities, challenges and progress. The Patient: Patient-Centered Outcomes Res. 2015;8(2):119–26.CrossRefGoogle Scholar
  22. 22.
    Anand P, Hunter G, Carter I, Dowding K, Guala F, Van Hees M. The development of capability indicators. J Hum Dev Capab. 2009;10(1):125–52.CrossRefGoogle Scholar
  23. 23.
    Lorgelly P, Lorimer K, Fenwick E, Briggs A. The capability approach: developing an instrument for evaluating public health interventions. Section of Public Health and Health Policy, University of Glasgow; 2008. http://www.gcph.co.uk/assets/0000/0430/Capabilities_-_full_report__August_08.pdf.
  24. 24.
    Nussbaum MC. Women and Human Development: The Capabilities Approach. New York: Cambridge University Press; 2000.CrossRefGoogle Scholar
  25. 25.
    Teerawattananon Y, Yamabhai I, Leelahavarong P. Using capability index to determine a value for money of the AIDS competence process in Thailand. Research Report, Health Intervention and Technology Assessment Program (HITAP), Thailand. 2011. http://aidscompetence.ning.com/forum/attachment/download?id=2028109%3AUploadedFile%3A122912.
  26. 26.
    Simon J, Anand P, Gray A, Rugkåsa J, Yeeles K, Burns T. Operationalising the capability approach for outcome measurement in mental health research. Soc Sci Med. 2013;98:187–96.PubMedCrossRefGoogle Scholar
  27. 27.
    Vergunst F, Jenkinson C, Burns T, Simon J. Application of Sen’s capability approach to outcome measurement in mental health research: psychometric validation of a novel multi-dimensional instrument (OxCAP-MH). Hum Welf. 2014;3:1–4.Google Scholar
  28. 28.
    Greco G. Assessing women’s quality of life in rural malawi: a capabilities index. PhD Thesis, London School of Hygiene and Tropical Medicine. 2013.Google Scholar
  29. 29.
    Greco G, Skordis-Worrall J, Mkandawire B, Mills A. What is a good life? Selecting capabilities to assess women’s quality of life in rural Malawi. Soc Sci Med. 2015;130:69–78.PubMedCrossRefGoogle Scholar
  30. 30.
    Kinghorn P, Robinson A, Smith RD. Developing a capability-based questionnaire for assessing well-being in patients with chronic pain. Soc Indic Res. 2015;120:897–916.CrossRefGoogle Scholar
  31. 31.
    Grewal I, Lewis J, Flynn T, Brown J, Bond J, Coast J. Developing attributes for a generic quality of life measure for older people: Preferences or capabilities? Soc Sci Med. 2006;62(8):1891–901.PubMedCrossRefGoogle Scholar
  32. 32.
    Al-Janabi H, Flynn TN, Coast J. Development of a self-report measure of capability wellbeing for adults: the ICECAP-A. Qual Life Res. 2012;21(1):167–76.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Sutton EJ, Coast J. Development of a supportive care measure for economic evaluation of end-of-life care using qualitative methods. Palliat Med. 2014;28(2):151–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Flynn TN, Louviere JJ, Peters TJ, Coast J. Best–worst scaling: what it can do for health care research and how to do it. J Health Econ. 2007;26(1):171–89.PubMedCrossRefGoogle Scholar
  35. 35.
    Coast J, Flynn TN, Natarajan L, Sproston K, Lewis J, Louviere JJ, Peters TJ. Valuing the ICECAP capability index for older people. Soc Sci Med. 2008;67(5):874–82.PubMedCrossRefGoogle Scholar
  36. 36.
    Burns T, Rugkåsa J, Molodynski A, Dawson J, Yeeles K, Vazquez-Montes M, Voysey M, Sinclair J, Priebe S. Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial. Lancet. 2013;381(9878):1627–33.PubMedCrossRefGoogle Scholar
  37. 37.
    Richardson J, Khan MA, Iezzi A, Maxwell A. Comparing and explaining differences in the magnitude, content, and sensitivity of utilities predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D multiattribute utility instruments. Med Decis Making. 2015;35(3):276–91.PubMedCrossRefGoogle Scholar
  38. 38.
    Davis JC, Bryan S, McLeod R, Rogers J, Khan K, Liu-Ambrose T. Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments. BMC Geriatrics. 2012;12(1):65.PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Makai P, Looman W, Adang E, Melis R, Stolk E, Fabbricotti I. Cost-effectiveness of integrated care in frail elderly using the ICECAP-O and EQ-5D: does choice of instrument matter? Eur J Health Econ. 2014. doi: 10.1007/s10198-014-0583-7
  40. 40.
    Jones C, Edwards RT, Hounsome B. Qualitative exploration of the suitability of capability based instruments to measure quality of life in family carers of people with dementia. ISRN Fam Med. 2014;2014:9.Google Scholar
  41. 41.
    EU Clinical Trials Register. Clinical efficacy and mechanistic evaluation of aflibercept for proliferative diabetic retinopathy (CLARITY). EudraCT number: 2013-003272-12. 2014. Available from: https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-003272-12/GB.
  42. 42.
    NIHR HTA programme. The PRE-EMPT Trial: Preventing REcurrance of Endometriosis by Means of long acting Progestogen Therapy, Protocol, NIHR Health Technology Assessment Programme HTA, no: 11/114; 2013.Google Scholar
  43. 43.
    Malley J, Netten A. Measuring outcomes of social care. Res Policy Plan. 2009;27(2):85–96.Google Scholar
  44. 44.
    Netten A, Burge P, Malley J, Potoglou D, Towers A-M, Brazier J, Flynn T, Forder J. Outcomes of social care for adults: developing a preference-weighted measure. Health Technol Assess. 2012;16(16):1–166.PubMedCrossRefGoogle Scholar
  45. 45.
    Netten A, Jones K, Knapp M, Fernandez JL, Challis D, Glendinning C, Jacobs S, Manthorpe J, Moran N, Stevens M. Personalisation through individual budgets: does it work and for whom? Br J Soc Work. 2012;42(8):1556–73.CrossRefGoogle Scholar
  46. 46.
    Bäumker T, Netten A, Darton R. Costs and outcomes of an extra care housing scheme in England. J Hous Elder. 2010;24(2):151–70.CrossRefGoogle Scholar
  47. 47.
    National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. London: NICE; 2008.Google Scholar
  48. 48.
    National Institute for Health and Care Excellence. Methods for the development of NICE public health guidance. 3rd ed. London: NICE; 2012.Google Scholar
  49. 49.
    Secnik K, Swensen A, Lage MJ. Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder. PharmacoEconomics. 2005;23(1):93–102.PubMedCrossRefGoogle Scholar
  50. 50.
    Loe IM, Feldman HM. Academic and educational outcomes of children with ADHD. J Pediatr Psychol. 2007;32(6):643–54.PubMedCrossRefGoogle Scholar
  51. 51.
    Fletcher J, Wolfe B. Long-term consequences of childhood ADHD on criminal activities. J Mental Health Policy Econ. 2009;12(3):119.Google Scholar
  52. 52.
    Matza LS, Secnik K, Mannix S, Sallee FR. Parent-proxy EQ-5D ratings of children with attention-deficit hyperactivity disorder in the US and the UK. PharmacoEconomics. 2005;23(8):777–90.PubMedCrossRefGoogle Scholar
  53. 53.
    Payne K, Thompson AJ. Economics of pharmacogenomics: rethinking beyond QALYs? Curr Pharmacogenomics Pers Med. 2013;11(3):187–95.CrossRefGoogle Scholar
  54. 54.
    Henderson C, Knapp M, Fernández J-L, Beecham J, Hirani SP, Cartwright M, Rixon L, Beynon M, Rogers A, Bower P. Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ. 2013;346:f1035.PubMedCrossRefGoogle Scholar
  55. 55.
    Davis JC, Bryan S, Marra CA, Sharma D, Chan A, Beattie BL, Graf P, Liu-Ambrose T. An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. PLoS One. 2013;8(5):e63031.PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Claxton K, Martin S, Soares M, Rice N, Spackman E, Hinde S, Devlin N, Smith PC, Sculpher M. Methods for the estimation of the National Institute for Health and Care Excellence cost-effectiveness threshold. Health Technol Assess. 2015; 19(14).Google Scholar
  57. 57.
    Sen AK. Choice, welfare and measurement. Cambridge: Harvard University Press; 1997.Google Scholar
  58. 58.
    Mitchell P, Roberts T, Barton P, Coast J. Applying the sufficient capability approach in health economic evaluations. In: presented at the Health Economists’ Study Group: Exeter. 2013.Google Scholar
  59. 59.
    Netten A, Beadle-Brown J, Caiels J, Forder J, Malley J, Smith N, Towers A-M. ASCOT: adult social care outcomes toolkit. Main guidance v2.1. In: PSSRU discussion paper 2716/3. 2011.Google Scholar
  60. 60.
    Keeley T, Al-Janabi H, Lorgelly P, Coast J. A qualitative assessment of the content validity of the ICECAP-A and EQ-5D-5L and their appropriateness for use in health research. PLoS One. 2013;8(12):e85287.PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    van Leeuwen KM, Bosmans JE, Jansen APD, Hoogendijk EO, van Tulder MW, van der Horst HE, Ostelo RW. Comparing measurement properties of the EQ-5D-3L, ICECAP-O, and ASCOT in frail older adults. Value Health. 2015;18(1):35–43.PubMedCrossRefGoogle Scholar
  62. 62.
    Lorgelly P. Cultural adaptation and capability instruments: more than translation and re-valuation. In: presented at the 3rd ICECAP Users Group Workshop: Birmingham. 2014.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Centre for Health Economics, Monash UniversityClaytonAustralia

Personalised recommendations