Mes: noviembre 2024

Value in Health, 27(9), pp. 1243-1250. (2024)

Autores: José María Abellán Perpiñán, Jorge E. Martínez Pérez, Fernando I. Sánchez Martínez y José Luis Pinto Prades.

Link

Abstract

Objectives: To demonstrate the feasibility of estimating a social tariff free of utility curvature and probability weighting biases and to test transferability between riskless and risky contexts. Methods: Valuations for a selection of EQ-5D health states were collected from a large and representative sample (N =1,676) of the Spanish general population through computer-assisted personal interviewing. Two elicitation methods were used: the traditional time trade-off (TTO), and a novel risky-TTO (rTTO) procedure. Both methods are equivalent for better than death states, which allowed us to test transferability of utilities across riskless and risky contexts. Corrective procedures applied are based on rank-dependent utility theory, identifying parameter estimates at the individual level. All corrections are health-state specific, which is a unique feature of our corrective approach. Results: Two corrected value sets for the EQ-5D-3L system are estimated, highlighting the feasibility of developing national tariffs under non-expected utility theories, sucha as rank-dependent utility. Furthermore, transferability was not supported for at least half of the health states valued by our sample. Conclusions: It is feasible to estimate a social tariff by using interviewing techniques, sample size, and sample representativeness equivalent to prior studies designed to generate national value sets for the EQ-5D. Utilities obtained in distinct contexts may not be interchangeable. Our findings caution against routinely taking transferability of utility for granted.

International Journal of Technology Assessment in Health Care, 40(1), e21, pp. 1-9. (2024)

Autores: Fernando I. Sánchez Martínez, José María Abellán Perpiñán, Jorge E. Martínez Pérez y Jorge Luis Gómez Torres

Link

Abstract

Objectives: This study aims to develop a framework for establishing priorities in the regional health service of Murcia, Spain, to facilitate the creation of a comprehensive multiple criteria decision analysis (MCDA) framework. This framework will aid in decision-making processes related to the assessment, reimbursement, and utilization of high-impact health technologies. Method: Based on the results of a review of existing frameworks for MCDA of health technologies, a set of criteria was proposed to be used in the context of evaluating high-impact health technologies. Key stakeholders within regional healthcare services, including clinical leaders and management personnel, participated in a focus group (n = 11) to discuss the proposed criteria and select the final fifteen. To elicit the weights of the criteria, two surveys were administered, one to a small sample of healthcare professionals (n = 35) and another to a larger representative sample of the general population (n = 494). Results: The responses obtained from health professionals in the weighting procedure exhibited greater consistency compared to those provided by the general public. The criteria more highly weighted were “Need for intervention” and “Intervention outcomes.” The weights finally assigned to each item in the multicriteria framework were derived as the equal-weighted sum of the mean weights from the two samples. Conclusions: A multi-attribute function capable of generating a composite measure (multicriteria) to assess the value of high-impact health interventions has been developed. Furthermore, it is recommended topilot this procedure in a specific decision context to evaluate the efficacy, feasibility, usefulness, and reliability of the proposed tool.

The European Journal of Health Economics, 25(8), pp. 1333-1343. (2024)

Autores: Jorge E. Martínez Pérez,José María Abellán Perpiñán, Fernando I. Sánchez Martínez y Juan José Ruiz López.

Link

Abstract

Aim. This paper reports the first estimation of an SF-6D value set based on the SF-12 for Spain. Methods. A representative sample (n = 1020) of the Spanish general population valued a selection of 56 hypothetical SF-6D health states by means of a probability lottery equivalent (PLE) method. The value set was derived using both random effects and mean models estimated by ordinary least squares (OLS). The best model was chosen on the basis of its predictive ability assessed in terms of mean absolute error (MAE). Results. The model yielding the lowest MAE (0.075) was that based on main effects using OLS. Pain was the most significant dimension in predicting health state severity. Comparison with the previous SF-6D (SF-36) model estimated for Spain revealed no significant differences, with a similar MAE (0.081). Nevertheless, the new SF-6D (SF-12) model predicted higher utilities than those generated by the SF-6D (SF-36) scoring algorithm (minimum value − 0.071 vs − 0.357). Conclusion. A value set for the SF-6D (SF-12) based on Spanish general population preferences elicited by means of a PLE technique is successfully estimated. The new estimated SF-6D (SF-12) preference-based measure provides a valuable tool for researchers and policymakers to assess the cost-effectiveness of new health technologies in Spain.

Hacienda Pública Española/ Review of Public Economics, 249(2/2024), pp. 83-107. (2024)

Autores: José María Abellán Perpiñán, Jorge E. Martínez Pérez, Fernando I. Sánchez Martínez y Jorge Luis Gómez Torres

Link

Abstract

This paper applies contingent valuation methodology to estimate the monetary value of the information contained in medicine leaflets. By surveying a sample of the general population, we obtain willingness-to-pay estimates of the value of providing additional quantitative information on potential benefits and side effects of a hypothetical medicine, according to the best evidence available about risk communication. The willingness-to-pay estimates found in our study ranged from 60 cents to 1 euro per month. In addition, some consistency tests of the robustness of our estimates are also presented, as well as evidence on their feasibility, reliability and validity.

Medical Decision Making, vol. 44(1), pp. 42-52. (2024)

Autores: José María Abellán Perpiñán, Jorge E. Martínez Pérez, José Luis Pinto Prades y Fernando I. Sánchez Martínez.

Link

Abstract

Objective. The main aim of this article is to test monotonicity in life duration. Previous findings suggest that, for poor health states, longer durations are preferred to shorter durations up to some threshold or maximum endurable time (MET), and shorter durations are preferred to longer ones after that threshold. Methods. Monotonicity in duration is tested through 2 ordinal tasks: choices and rankings. A convenience sample (n = 90) was recruited in a series of experimental sessions in which participants had to rank-order health episodes and to choose between them, presented in pairs. Health episodes result from the combination of 7 EQ-5D-3L health states and 5 durations. Monotonicity is tested comparing the percentage rate of participants whose preferences were monotonic with the percentage of participants with nonmonotonic preferences for each health state. In addition, to test the existence of preference reversals, we analyze the fraction of people who switch their preference from rankings to choices. Results. Monotonicity is frequently violated across the 7 EQ-5D health states. Preference patterns for individuals describe violations ranging from almost 49% with choices to about 71% with rankings. Analysis performed by separate states shows that the mean rates of violations with choices and ranking are about 22% and 34%, respectively. We also find new evidence of preference reversals and some evidence—though scarce—of transitivity violations in choices. Conclusions. Our results show that there is a medium range of health states for which preferences are nonmonotonic. These findings support previous evidence on MET preferences and introduce a new ‘‘choice-ranking’’ preference reversal. It seems that the use of 2 tasks with a similar response scale may make preference reversals less substantial, although it remains important and systematic.