Do individuals consider expected income when valuing health states?

Area of Science:

• Health Economics
• Decision Analysis
• Psychometrics

Background:

• Cost-effectiveness analysis (CEA) is crucial for healthcare resource allocation.
• Accurately valuing health states is essential for CEA.
• The inclusion of productivity costs in CEA remains a complex issue.

Purpose of the Study:

• To determine if individuals incorporate expected income into health state valuations.
• To inform the methodology for incorporating productivity costs in CEA.

Main Methods:

• Two hundred students valued four health states using time trade-off (TTO) and visual analogue scale (VAS).
• Participants were randomly assigned to groups that either considered income or did not.
• Valuations were compared between the income and non-income groups.

Main Results:

• Health state valuations were lower in the income group for income-affecting states.
• 96% of the non-income group did not consider income; 40% of the income group believed income affected their valuations.
• Explicitly prompting income consideration influenced health state valuations.

Conclusions:

• Individuals generally do not consider expected income in health state valuations without prompting.
• Productivity costs are likely not captured in standard health state valuations.
• Productivity costs should be explicitly included in cost-effectiveness analyses.