The effect of chronic conditions on stated preferences for health

While patients tend to value their own health state systematically higher than others would rate it, it is less clear whether stated preferences for hypothetical health states differ between persons with and without specific medical conditions. The aim of this study was to determine if specific conditions affect the valuation of health using a generic measure.

Using data from the US Valuation of EQ-5D Health States (n = 3,773), we focused on six conditions of interest (COI), e.g., arthritis, diabetes, depression, heart failure, cancer, and hay fever, and time trade-off values for 12 of 243 EQ-5D health states. For each COI, regression models compared differences in pooled health state preferences among four groups: COI, COI plus one or more additional conditions, no COI but other conditions, or no chronic conditions.

No differences in health state preferences were found among the four groups for any of the COIs except for patients with cancer and additional conditions, whose mean scores were 0.07 lower compared to no chronic conditions (P < 0.01). The strongest predictors of health state preferences were race/ethnicity, age, and marital status.

Most self-reported chronic conditions had a trivial impact on preferences for hypothetical health states, which suggests that utility algorithms for generic preference-based measures will be similar when estimated from preferences of the general population or patients with chronic illness, conceivably because both types of respondents have not experienced many health states in the classifier system.