Estimating sign-dependent societal preferences for quality of life

Attema, Arthur and Brouwer, Werner and l'Haridon, Olivier and Pinto, Jose Luis (2014): Estimating sign-dependent societal preferences for quality of life.

Abstract

This paper is the first to apply prospect theory to societal health-related decision making. In particular, we allow for utility curvature, equity weighting, sign-dependence, and loss aversion in choices concerning quality of life of other people. We find substantial inequity aversion, both for gains and losses, which can be attributed to both diminishing marginal utility and differential weighting of better-off and worse-off. There are also clear framing effects, which violate expected utility. Moreover, we observe loss aversion, indicating that respondents give more weight to one group’s loss than another group’s gain of the same absolute magnitude. We also elicited some information on the effect of the age of the studied group. The amount of inequity aversion is to some extent influenced by the age of the considered patients. In particular, more inequity aversion is observed for gains of older people than gains of younger people.

• Item Type: MPRA Paper
• Language: English
• Keywords: equity weighting, loss aversion, prospect theory, QALYs
• Subjects: D - Microeconomics > D6 - Welfare Economics > D63 - Equity, Justice, Inequality, and Other Normative Criteria and Measurement; I - Health, Education, and Welfare > I1 - Health > I10 - General

References

-Abasolo I, Tsuchiya A. Exploring social welfare functions and violation of monotonicity: an example from inequalities in health. Journal of Health Economics 2004;23; 313-329.

-Abásolo I, Tsuchiya A. Is more health always better for society? Exploring public preferences that violate monotonicity. Theory and Decision 2013;74; 539-563.

-Abdellaoui M, Bleichrodt H, l'Haridon O. A tractable method to measure utility and loss aversion under prospect theory. Journal of Risk and Uncertainty 2008;36; 245-266.

-Andersson F, Lyttkens CH. Preferences for equity in health behind a veil of ignorance. Health Economics 1999;8; 369-378.

-Atkinson AB. On the measurement of inequality. Journal of Economic Theory 1970;2; 244-263.

-Attema AE, Brouwer WBF, l'Haridon O. Prospect theory in the health domain: A quantitative assessment. Journal of Health Economics 2013;32; 1057-1065.

-Attema AE, Brouwer WBF, l'Haridon O, Pinto-Prades J. An elicitation of utility over QALYs under prospect theory. Work in progress. 2014.

-Bleichrodt H, Diecidue E, Quiggin J. Equity weights in the allocation of health care: the rank-dependent QALY model. Journal of Health Economics 2004;23; 157-171.

-Bleichrodt H. Health utility indices and equity considerations. Journal of Health Economics 1997;16; 65-91.

-Bleichrodt H, Doctor J, Stolk E. A nonparametric elicitation of the equity-efficiency trade-off in cost-utility analysis. Journal of Health Economics 2005;24; 655-678.

-Bleichrodt H, Miyamoto J. A Characterization of Quality-Adjusted Life-Years Under Cumulative Prospect Theory. Mathematics of Operations Research 2003;28; 181-193.

-Bosworth R, Cameron TA, DeShazo JR. Demand for environmental policies to improve health: Evaluating community-level policy scenarios. Journal of Environmental Economics and Management 2009;57; 293-308.

-Brouwer WBF, van Exel NJA. Expectations regarding length and health related quality of life: Some empirical findings. Social Science & Medicine 2005;61; 1083-1094.

-Brouwer WBF, van Exel NJA, Stolk EA. Acceptability of less than perfect health states. Social Science & Medicine 2005;60; 237-246.

-Cuadras-Morató X, Pinto-Prades J, Abellán-Perpiñán J. Equity considerations in health care: the relevance of claims. Health Economics 2001;10; 187-205.

-Dolan P. The measurement of individual utility and social welfare. Journal of Health Economics 1998;17; 39-52.

-Dolan P, Robinson A. The measurement of preferences over the distribution of benefits: The importance of the reference point. European Economic Review 2001;45; 1697-1709.

-Dolan P, Shaw R, Tsuchiya A, Williams A. QALY maximisation and people's preferences: a methodological review of the literature. Health Economics 2005;14; 197-208.

-Dolan P, Tsuchiya A. Determining the parameters in a social welfare function using stated preference data: an application to health. Applied Economics 2011;43; 2241-2250.

-Johannesson M, Gerdtham U. A note on the estimation of the equity-efficiency trade-off for QALYs. Journal of Health Economics 1996;15; 359-368.

-Johannesson M, Johansson P. Is the valuation of a QALY gained independent of age? Some empirical evidence. Journal of Health Economics 1997;16; 589-599.

-Kahneman D, Tversky A. Prospect Theory: An Analysis of Decision under Risk. Econometrica 1979;47; 263-291.

-Lindholm L, Rosén M. On the measurement of the nation's equity adjusted health. Health Economics 1998;7; 621-628.

-Nord E, Pinto JL, Richardson J, Menzel P, Ubel P. Incorporating societal concerns for fairness in numerical valuations of health programmes. Health Economics 1999;8; 25-39.

-Péntek M, Brodszky V, Gulácsi ÁL, Hajdú O, van Exel J, Brouwer W, Gulácsi L. Subjective expectations regarding length and health-related quality of life in Hungary: results from an empirical investigation. Health Expectations 2012; n/a-n/a.

-Polman E. Self–other decision making and loss aversion. Organizational Behavior and Human Decision Processes 2012;119; 141-150.

-Shalev J. Loss Aversion and Bargaining. Theory and Decision 2002;52; 201-232.

-Turpcu A. Essays on the equitable distribution of healthcare,Proquest Umi Dissertation Publishing; 2013.

-Tversky A, Kahneman D. Advances in Prospect Theory: Cumulative Representation of Uncertainty. Journal of Risk and Uncertainty 1992;5; 297-323.

-Wagstaff A. QALYs and the equity-efficiency trade-off. Journal of Health Economics 1991;10; 21-41.

-Wakker PP. Prospect theory: For risk and ambiguity, Cambridge: Cambridge University Press; 2010.

-Wakker P, Deneffe D. Eliciting von Neumann-Morgenstern Utilities When Probabilities Are Distorted or Unknown. Management Science 1996;42; 1131-1150.

-Williams A. Intergenerational Equity: An Exploration of the 'Fair Innings' Argument. Health Economics 1997;6; 117-132.