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Should Cost‐Effectiveness Analysis Include the Cost of Consumption Activities? AN Empirical Investigation
Author(s) -
Adarkwah Charles Christian,
Sadoghi Amirhossein,
Gandjour Afschin
Publication year - 2016
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3162
Subject(s) - valuation (finance) , consumption (sociology) , cost effectiveness analysis , time trade off , quality of life (healthcare) , cost–utility analysis , quality adjusted life year , health economics , medicine , cost–benefit analysis , public health , actuarial science , health care , cost effectiveness , economics , operations management , nursing , ecology , social science , finance , sociology , biology , economic growth
Abstract There has been a debate on whether cost‐effectiveness analysis should consider the cost of consumption and leisure time activities when using the quality‐adjusted life year as a measure of health outcome under a societal perspective. The purpose of this study was to investigate whether the effects of ill health on consumptive activities are spontaneously considered in a health state valuation exercise and how much this matters. The survey enrolled patients with inflammatory bowel disease in Germany ( n = 104). Patients were randomized to explicit and no explicit instruction for the consideration of consumption and leisure effects in a time trade‐off (TTO) exercise. Explicit instruction to consider non‐health‐related utility in TTO exercises did not influence TTO scores. However, spontaneous consideration of non‐health‐related utility in patients without explicit instruction (60% of respondents) led to significantly lower TTO scores. Results suggest an inclusion of consumption costs in the numerator of the cost‐effectiveness ratio, at least for those respondents who spontaneously consider non‐health‐related utility from treatment. Results also suggest that exercises eliciting health valuations from the general public may include a description of the impact of disease on consumptive activities. Copyright © 2015 John Wiley & Sons, Ltd.