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. 2022 Aug;31(8):1633-1648.
doi: 10.1002/hec.4529. Epub 2022 Apr 26.

Correcting for discounting and loss aversion in composite time trade-off

Stefan A Lipman  1 , Arthur E Attema  1 , Matthijs M Versteegh  2
Affiliations

Correcting for discounting and loss aversion in composite time trade-off

Stefan A Lipman et al. Health Econ. 2022 Aug.

Abstract

Time trade-off utilities have been suggested to be biased upwards. This bias is a result of the method being applied assuming linear utility of life duration, which is violated when individuals discount future life years or are loss averse for health. Applying a "corrective approach", that is, measuring individuals' discount function and loss aversion and correcting time trade-off utilities for these individual characteristics, may reduce this bias in utilities. Earlier work has developed this approach for time trade-off in a student sample. In this study, the corrective approach was extended to composite time trade-off (cTTO) methodology, which enabled correcting utilities for health states worse than dead. In digital interviews a sample of 150 members of the general public completed cTTO tasks for six health states, and afterward they completed measurements of loss aversion and discounting. cTTO utilities were corrected using these measurements under multiple specifications. Respondents were also asked to reflect on and adjust their cTTO utilities directly. Our results show considerable loss aversion and both positive and negative discounting were prevalent. As predicted, correction generally resulted in lower utilities. This was in accordance with the direction of adjustments made by respondents themselves.

Keywords: discounting; loss aversion; reference-dependence; time trade-off.

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Conflict of interest statement

Matthijs Versteegh is a member of the EuroQol Group. All authors have received research grants from the EuroQol Research Foundation for work outside the scope of the submitted work.

Figures

FIGURE 1
FIGURE 1
Mean utilities for all six health states elicited in this experiment
See this image and copyright information in PMC

References

    1. Abdellaoui, M. , Bleichrodt, H. , L’haridon, O. , & Van Dolder, D. (2016). Measuring loss aversion under ambiguity: A method to make prospect theory completely observable. Journal of Risk and Uncertainty, 52, 1–20. 10.1007/s11166-016-9234-y - DOI
    1. Alava, M. H. , Pudney, S. , & Wailoo, A. (2020). The EQ‐5D‐5L value set for England: Findings of a quality assurance program. Value in Health, 23(5), 642–648. - PubMed
    1. Attema, A. E. , Bleichrodt, H. , & Wakker, P. P. (2012). A direct method for measuring discounting and QALYs more easily and reliably. Medical Decision Making, 32(4), 583–593. 10.1177/0272989x12451654 - DOI - PubMed
    1. Attema, A. E. , & Brouwer, W. B. (2009). The correction of TTO‐scores for utility curvature using a risk‐free utility elicitation method. Journal of Health Economics, 28(1), 234–243. 10.1016/j.jhealeco.2008.10.004 - DOI - PubMed
    1. Attema, A. E. , & Brouwer, W. B. (2014). Deriving time discounting correction factors for TTO tariffs. Health Economics, 23(4), 410–425. 10.1002/hec.2921 - DOI - PubMed

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