{"title":"Is anchoring at ‘dead’ a theoretical requirement for health state valuation?","authors":"Chris Sampson, David Parkin, Nancy Devlin","doi":"10.1002/hec.4863","DOIUrl":null,"url":null,"abstract":"<p>Values that accompany generic health measures are typically anchored at 1 = full health and 0 = dead. Some health states may then be considered ‘worse than dead’ (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at ‘dead = 0’ is necessary for quality-adjusted life year (QALY) estimation. We summarise the role of ‘dead’ in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require ‘dead’; (ii) whether ‘dead’ needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost-effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 9","pages":"1929-1935"},"PeriodicalIF":2.0000,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.4863","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health economics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hec.4863","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
Values that accompany generic health measures are typically anchored at 1 = full health and 0 = dead. Some health states may then be considered ‘worse than dead’ (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at ‘dead = 0’ is necessary for quality-adjusted life year (QALY) estimation. We summarise the role of ‘dead’ in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require ‘dead’; (ii) whether ‘dead’ needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost-effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse.
期刊介绍:
This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems.
Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses.
Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.