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Valuing Health for Regulatory Cost-Effectiveness Analysis (2006)
Board on Health Care Services (HCS)

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National Research Council. "Appendix A Summary of Case Studies ." Valuing Health for Regulatory Cost-Effectiveness Analysis. Washington, DC: The National Academies Press, 2006. 1. Print.

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Valuing Health for Regulatory Cost-Effectiveness Analysis

TABLE A-2 Without-Condition HRQL

 

Age 20

Age 40

Age 60

Age 80

Mean Population Index Value (base case)

EQ-5D

0.92

0.88

0.83

0.75

HUI-2 and 3

0.91

0.88

0.82

0.69

SF-6D

0.84

0.82

0.79

0.72

QWB

0.82

0.80

0.74

0.65

Perfect Health (sensitivity analysis)

All indices

1.0

1.0

1.0

1.0

NOTES: See Hanmer et al. (2006) for updated estimates and information on uncertainty. Table presents results rounded to two significant figures for selected age groups. Unrounded estimates for each year of age are used in all calculations. SOURCES: EQ-5D: Unpublished analysis by William Lawrence, November 9, 2004. HUI-3: Unpublished analysis by Barbara Altman, January 7, 2005. SF-6D: Unpublished analysis by Janel Hanmer, January 24, 2005. QWB: Unpublished analysis by John Anderson, April 21, 2005.

ranges, average health would remain constant at the value reported for the eldest age group. This approach means that the HRQL impacts for young children will be the same regardless of whether the comparison is to perfect or average health, since a value of 1.0 is used for “without condition” HRQL in both cases.7

Table A-2 presents the estimates of average population health used in this analysis for selected ages, for males and females combined. These estimates are provided for illustrative purposes; the case study calculations used the full range of estimates available for each age group.

As is evident from the table, the estimates of average population health vary. This variation reflects several factors, including the differences in (1) the population surveyed to determine their health-related attributes; (2) the underlying valuation survey; and (3) the construction of indexes themselves. In combination, these factors generally lead to the highest average HRQL estimates under the EQ-5D and the lowest under the QWB. As expected, average HRQL declines with age under each index.

The comparison of HRQL with and without the conditions of concern is complicated by the assumptions that underlie the approach used to assign and value attributes under each index. In these comparisons, we adjusted the values depending on the source of the “with condition” esti-

7  

The assumption that average HRQL for infants and children is close to optimal and can be approximated by an index value of 1.0 may not be well founded, however. Some surveys of children’s self-reported HRQL have reported lower values (Hennessy and Kind, 2002).

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