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There is an ongoing debate on the allocation of resources in health care: Who should be asked - patients or the general public?
Patients perceive their own health state differently than the general public asked about the same condition - with potential consequences on the assessment of quality-adjusted life years (QALYs). In the light of a theory by the Nobel Prize laureate in economics 2002, psychologist Daniel Kahneman, and Amos Tversky, the difference seems to be a matter of reference points. Their so-called "Prospect Theory" implies that health states are either coded as gains or losses, with consequences on individual risk attitudes.
A recent study, "Health Valuation Methods and Reference Points: the Case of Tinnitus", published in Value in Health, has investigated to what extent individual risk attitudes, i.e. the reference points, drive perceptions apart. Indeed, patients and people from the general public differed in preference-based health state valuations exclusively due to their different risk attitudes. The study was co-authored by Michael Happich, J旦rn Moock, and Thomas von Lengerke, a multidisciplinary team from Munich, Greifswald and Hannover (economics, sociology, and psychology).
Says Dr. Happich, "This approach shows the way ahead to align health state valuations elicited from the general public (for reasons of democratic legitimization) with the illness experience of patients."
The future role of reference points will be discussed in Value in Health, the official journal of the International Society for Pharmacoeconomics and Outcomes Research.
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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