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Valuing SF-6D Health States Using a Discrete Choice Experiment
Richard Norman1, Rosalie Viney1, John Brazier2
1Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia (RN, RV, PC)
Discrete choice experiments (DCEs) provide new Australian SF-6D utility weights, overcoming standard gamble limitations. These weights, reflecting physical functioning and mental health, are crucial for cost-utility analyses.
Area of Science:
- Health Economics
- Psychometrics
- Biostatistics
Background:
- Standard gamble (SG) methods for SF-6D utility weights show a floor effect.
- Discrete choice experiments (DCEs) offer an alternative elicitation technique for utility weights.
- Previous methods lacked Australian-specific SF-6D utility weights.
Purpose of the Study:
- To derive Australian utility weights for the SF-6D using DCE methods.
- To explore the application of DCEs for estimating utility weights.
- To provide an algorithm for Australian cost-utility analyses.
Main Methods:
- An online DCE was administered to 1017 Australian participants.
- Random-effects probit models estimated preferences, including nonlinearities in life expectancy.
- A preference index was calculated, valuing full health at 1 and death at 0.
Main Results:
- Physical functioning, pain, mental health, and vitality significantly influenced utility weights.
- Combining health state levels did not negatively impact model fit.
- The range of utility weights was wider than international SG-derived weights, with 5% of states valued below zero.
Conclusions:
- DCEs are effective for estimating utility weights for multi-attribute instruments like the SF-6D.
- Australian cost-utility analyses can now utilize these domestic SF-6D weights.
- Further research should compare DCE-derived weights with other elicitation methods for quality-adjusted life-year calculations.
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