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The better than dead method: feasibility and interpretation of a valuation study
R A van Hoorn1, A R T Donders, M Oppe
1Department for Health Evidence, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, Ralph.vanHoorn@radboudumc.nl.
Pharmacoeconomics
|May 22, 2014
Summary
The Better than Dead (BTD) method is a feasible and reliable way to value health states, addressing limitations of traditional methods. This approach allows for the quantification of time-dependent health values.
Area of Science:
- Health Economics
- Psychometrics
- Decision Science
Background:
- Traditional health state valuation methods struggle with negative values and time dependency.
- The Better than Dead (BTD) method offers a potential solution by comparing health states to being dead.
- BTD aims to overcome limitations in valuing health states worse than death.
Purpose of the Study:
- To assess the feasibility of the Better than Dead (BTD) method for the EQ-5D system.
- To determine if BTD can reliably estimate health state values.
- To explore the application of BTD in health economics.
Main Methods:
- A web-based questionnaire administered to 291 Dutch respondents (aged 18-45).
- Elicitation of preferences for 50 health states across six durations (1-40 years).
- Random-effects models used for value estimation; test-retest reliability assessed in 41 respondents.
Main Results:
- Religious life stance and educational level were significant determinants in BTD valuations.
- Faster response times correlated with preferring health states over death and lower test-retest reliability.
- Few 'maximal endurable time' states were identified, indicating limited aversion to prolonged states.
Conclusions:
- The Better than Dead (BTD) method is a feasible and reliable tool for health state valuation.
- Further research is needed to understand how experimental settings influence time-dependent value estimations.
- BTD offers a promising approach for improving health economic evaluations.
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