Using a discrete choice experiment to estimate health state utility values

Area of Science:

• Health Economics
• Psychometrics
• Decision Science

Background:

• The EQ-5D is a widely used measure of health status, but accurately valuing its health states, especially those considered worse than dead, remains challenging.
• The current standard method for valuing EQ-5D health states is the time trade off (TTO) task, which has known limitations.

Purpose of the Study:

• To explore a novel application of the discrete choice experiment (DCE) as an alternative to the time trade off (TTO) task for estimating health utility values.
• To assess the feasibility and validity of using DCE to derive health utility values on the EQ-5D scale.

Main Methods:

• A survey was conducted using a sample of English-speaking Canadians.
• The discrete choice experiment (DCE) was administered alongside the traditional time trade off (TTO) task.
• Data collected were analyzed to compare the values derived from both methods.

Main Results:

• The discrete choice experiment (DCE) successfully derived logical and consistent health utility values for EQ-5D health states, including those valued as worse than dead.
• The DCE method resulted in fewer data exclusions compared to the TTO task.
• The DCE approach integrated values worse than dead without requiring a separate valuation procedure.

Conclusions:

• The discrete choice experiment (DCE) offers a promising alternative to the time trade off (TTO) for valuing EQ-5D health states.
• This novel DCE application provides more robust and inclusive health utility values, representing a broader range of respondent preferences.
• The findings have significant implications for improving the accuracy and comprehensiveness of health valuation studies.