Estimating optimal willingness to pay thresholds for cost-effectiveness analysis: A generalized method.
Health Econ
; 30(7): 1697-1702, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33884694
ABSTRACT
Operationalizing cost-effectiveness analysis (CEA) requires that decisionmakers select maximum willingness to pay thresholds (K). We generalize previous methods used to estimate K using highly flexible hyperbolic absolute risk aversion (HARA) utility functions that encompass a wide range of risk behavior. For HARA utility, we calculate formulas for relative risk aversion (r*) and relative prudence (π∗ ), using literature-based estimates to calibrate our HARA model. We then assess optimal WTP thresholds (K) in absolute value and relative to income (K/M). Across the most-plausible range of risk preference parameters (r* and π∗ ), optimal K/M ratios sit (approximately) in the range of 1 to 3, although we cannot readily rule out larger K/M values. The optimal K always increases with income, while K/M falls with income if utility has increasing relative risk aversion. Results of this more-general model of economic utility are broadly consistent with previous work using more-restrictive Weibull functions. More precision in measuring the key parameters-particularly relative prudence (π∗ ) will narrow down the range of K/M estimates. The highly general HARA structure illuminates why and how optimal CEA thresholds change with income. An appendix illuminates how relative risk aversion and relative prudence relate to each other.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Serviços de Saúde
/
Renda
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Health Econ
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos