Valuing Health: Does Enriching a Scenario Lead to Higher Utilities?

Abstract

Patients have been found to value their own experienced health state higher than an investigator-constructed scenario of that health state. The aim of this study was to investigate if patients value their own experienced health state higher than a standard EQ-5D scenario of their health state and if "enriching'' this scenario by adding individualized attributes reduces the differences between experienced health and the scenario. Face-to-face interviews were held with 129 patients with rheumatoid arthritis. Patients were asked to value in a time tradeoff their own experienced health; 6 standard EQ-5D scenarios, of which the 5th (untold to them) represented their own health state; and a standard EQ-5D scenario of their health state (identified as such) enriched with individual attributes. The own experienced health state was not valued differently from the own standard EQ-5D state and was lower compared to the own enriched EQ-5D state of that same health state. An interaction effect was found for health status. Patients with better health did not report different values for their own experienced health compared with their own standard EQ-5D description; their own experienced state was rated lower than their own enriched EQ-5D description. Patients with poor health valued all 3 health states similarly. Surprisingly, utilities for scenarios enriched with exclusively negative individual attributes were not lower than those for the own standard EQ-5D description. The hypothesis that disparities in valuation can be attributed to EQ-5D description being too sparse was not confirmed.