Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Health Service Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia.
Eur J Health Econ. 2021 Apr;22(3):365-380. doi: 10.1007/s10198-020-01260-2. Epub 2021 Jan 21.
Economic evaluations often use preference-based value sets (tariffs) for health-related quality of life to quantify health effects. For wellbeing at the end of life, issues beyond health-related quality of life may be important. Therefore, the ICECAP Supportive Care Measure (ICECAP-SCM), based on the capability approach, was developed. A validated German ICECAP-SCM version was published recently. However, tariffs for the German ICECAP-SCM are not available. Therefore, the aim was to determine tariffs for the ICECAP-SCM based on preferences of the German general population.
An online sample of 2996 participants completed a best-worst scaling (BWS) and a discrete choice experiment (DCE). BWSs required participants to choose the best and worst statement within the same capability state, whereas DCEs required participants to trade-off between two capability states. First, BWS and DCE data were analyzed separately. Subsequently, combined data were analyzed using scale-adjusted conditional logit latent class models. Models were selected based on the stability of solutions and the Bayesian information criterion.
The two latent class model was identified to be optimal for the BWS, DCE, and combined data, and was used to derive tariffs for the ICECAP-SCM capability states. BWS data captured differences in ICECAP-SCM scale levels, whereas DCE data additionally explained interactions between the seven ICECAP-SCM attributes.
The German ICECAP-SCM tariffs can be used in addition to health-related quality of life to quantify effectiveness in economic evaluations. The tariffs based on BWS data were similar for Germany and the UK, whereas the tariffs based on combined data varied. We would recommend to use tariffs based on combined data in German evaluations. However, only results on BWS data are comparable between Germany and the UK, so that tariffs based on BWS data should be used when comparing results between Germany and the UK.
经济评估通常使用偏好基础的价值量表（关税）来衡量健康相关生活质量，以量化健康效应。对于生命末期的幸福感，可能存在超出健康相关生活质量的问题。因此，基于能力方法开发了 ICECAP 支持性护理测量量表（ICECAP-SCM）。最近发表了经过验证的德国 ICECAP-SCM 版本。然而，德国 ICECAP-SCM 的关税尚不可用。因此，本研究旨在确定基于德国普通人群偏好的 ICECAP-SCM 关税。
一个由 2996 名参与者组成的在线样本完成了最佳最差量表（BWS）和离散选择实验（DCE）。BWS 要求参与者在同一能力状态内选择最佳和最差的陈述，而 DCE 则要求参与者在两个能力状态之间进行权衡。首先，分别分析 BWS 和 DCE 数据。随后，使用调整规模的条件逻辑潜在类别模型对综合数据进行分析。根据解决方案的稳定性和贝叶斯信息准则选择模型。
两种潜在类别模型被确定为 BWS、DCE 和综合数据的最佳模型，并用于为 ICECAP-SCM 能力状态推导出关税。BWS 数据捕捉了 ICECAP-SCM 量表水平的差异，而 DCE 数据还解释了七个 ICECAP-SCM 属性之间的相互作用。
德国 ICECAP-SCM 关税可与健康相关生活质量一起用于经济评估中以衡量效果。基于 BWS 数据的关税在德国和英国相似，而基于综合数据的关税则有所不同。我们建议在德国评估中使用基于综合数据的关税。然而，德国和英国之间仅在 BWS 数据上的结果具有可比性，因此在德国和英国之间比较结果时，应使用基于 BWS 数据的关税。
