Time and lexicographic preferences in the valuation of EQ-5D-Y with time trade-off methodology

Stefan A. Lipman (), Liying Zhang, Koonal K. Shah and Arthur Attema
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Stefan A. Lipman: Erasmus University Rotterdam
Liying Zhang: Erasmus University Rotterdam
Koonal K. Shah: National Institute for Health and Care Excellence

The European Journal of Health Economics, 2023, vol. 24, issue 2, No 11, 293-305

Abstract: Abstract In the valuation of EQ-5D-Y-3L, adult respondents are asked to complete composite time trade-off (cTTO) tasks for a 10-year-old child. Earlier work has shown that cTTO utilities elicited in such a child perspective are generally higher than when adults take their own perspective. We explore how differences in time preference in child and adult perspectives could explain this effect. Furthermore, as cTTO valuation in a child perspective involves explicit consideration of immediate death for a child, we also consider how cTTO utilities could be affected by decision-makers lexicographically avoiding death in children. We report the results of an experiment in which 219 respondents valued 5 health states in both adult and child perspectives with either a standard cTTO or a lead-time TTO only approach, in which immediate death is less focal. Time preferences were measured in both perspectives. Our results suggest that utilities were lower when lead-time TTO, rather than cTTO, was used. We find large heterogeneity in time preference in both perspectives, with predominantly negative time preference. The influence of time preferences on utilities, however, was small, and correcting for time preferences did not reduce differences between utilities elicited in both perspectives. Surprisingly, we found more evidence for differences in utilities between adult and child perspectives when lead-time TTO was used. Overall, these results suggest that time and lexicographic preferences affect time trade-off valuation in child and adult perspectives, but are not the explanation for differences between these perspectives. We discuss the implications of our findings for EQ-5D-Y-3L valuation.

Keywords: Time trade-off; Health state valuation; EQ-5D-Y; Time preferences; Lexicographic preferences; Perspective (search for similar items in EconPapers)
JEL-codes: I10 (search for similar items in EconPapers)
Date: 2023
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-022-01466-6

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