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New health care technologies are increasingly evaluated in order to see whether they provide sufficient value (i.e. improved quality of life) for money. The outcomes can be used to decide on whether such a technology should be funded.
However, such decisions can only be made correctly, if we measure costs and health effects in a valid and appropriate way. One of the remaining questions is whether income losses due to illness-related reduced productivity should be captured as costs (i.e. as money) or as health effects (i.e. as quality of life). This crucially depends on what people consider when valuing health states, but so far, this remains largely unknown.
Therefore, it is crucial to gather more information on this issue, since the effects on outcomes of the choice between costs and effects can be very substantial and thus influence decision making. A recent study, "Breaking the silence: Exploring the potential effects of explicit instructions on incorporating income and leisure in TTO exercises," published in Value in Health, presents an experiment to assess the influence of income on health state valuations. The study was co-authored by Marieke Krol and Werner Brouwer of the Erasmus Medical Center in Rotterdam and Pedram Sendi from the Basel University.
The influence of income on health state valuations was investigated before by these authors and for instance published inPharmacoEconomics in 2006 (issue 4, pages 401-414).
"Our results largely support the inclusion of productivity costs as costs and not as effects," says first author Marieke Krol, MSc. "This is important since this contradicts the US guidelines on this matter and may have a large impact on results of economic evaluations and subsequent decisions."
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 3,000 clinicians, decision-makers, and researchers worldwide.
ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.
Value in Health Volume 12 Issue 1 - January/February 2009
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http://www.ispor.org
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