Ruhr Graduate School in Economics and University of Duisburg-Essen, Dorothea-Bernstein-Weg 13, 22081, Hamburg, Germany.
University of Basel, Basel, Switzerland.
Eur J Health Econ. 2017 Jul;18(6):685-696. doi: 10.1007/s10198-016-0818-x. Epub 2016 Jul 28.
Patients and non-patients tend to attach different utility values to the state of suffering from specific illnesses. This observation naturally leads to the question whose utility values should be used as the basis in cost-effectiveness analysis (CEA). Intuitively, one would presume that patients are better informed about the consequences of their illness, and public authorities should, therefore, use the patients' utility values in CEA. Contrary to this presumption, it has been argued that society at large should determine which values are to be used and not the patients because, in the end, it is societal resources that are to be allocated. Against this background, we use data from a discrete choice experiment (DCE) that was completed by patients of rheumatoid arthritis (RA) and non-patients to explore the discrepancies between the two groups' utility estimates for typical consequences of RA. Our results indicate that both groups attach remarkably similar part-worth utilities to the symptoms pain, fatigue, and functional limitations. However, non-patients significantly undervalue the ability to work when compared to patients.
患者和非患者往往对特定疾病的患病状态赋予不同的效用值。这种观察自然会引出一个问题，即应该使用谁的效用值作为成本效益分析（CEA）的基础。直观地说，人们会认为患者更了解自己疾病的后果，因此，公共当局应该在 CEA 中使用患者的效用值。与这种假设相反，有人认为，应该由整个社会来决定使用哪些价值观，而不是患者，因为最终需要分配的是社会资源。在此背景下，我们使用了一项由类风湿关节炎（RA）患者和非患者完成的离散选择实验（DCE）的数据，来探讨两组对 RA 典型后果的效用估计之间的差异。我们的结果表明，两组对疼痛、疲劳和功能障碍等 RA 症状的部分重要性效用评估非常相似。然而，与患者相比，非患者显著低估了工作能力的价值。
