药物经济学中效用基本概念.pptVIP

Measuring health utilities for economic evaluation  What is utility? o In economics, utility is a measure of relative satisfaction It is a term referring to the total satisfaction received by a consumer trom consuming a good or service  Preference, value, utility o Preference is greater liking/desire toward something over others o Value measures preference under certainty o Utility measures preference under uncertainty What is the utility in cost utility analysis?  Health utility OA single measure for multiple (composite? ) health outcomes(i.e effectiveness, and side effects) 口 Anchored at o for dead and1 for ful‖l health a Comparability across different treatments or diseases  von Neumann-Morgenstern utility theory A mathematical decision theory describing how a rational individual should make decisions when faced with uncertain outcomes von Neumann and morgenstern 1944  Axioms of VNM utility theory o Existence and transitivity of preference A)b or a(B AN B If ab and Bc, then A)c If a- band bc. then a c Independence of preference If a)b then pA+(1-pC pB+(1-pC Continuity of preference If A)Band BC, then existing a probability p, B IpA +(1-pc  How to measure health utilities? a With established elicitation techniques Direct measure Designing your own questionnaire/protocol Applying directly elicitation techniques Indirect measure Use of established questionnaire Calculating health utilities using scoring algorithms based on elicitation techniques a Without established elicitation techniques Judgment  Direct measures avisual analogue scale (vas 口 Standard gamble(SG) 口 Time trade-off(TTo) DIscrete choice experiment(DCE)  Steps for direct measurement Step One Developing health state descriptions Step Two Eliciting preferences Step Three Calculating health utilities  Visual Analogue Scale(VAs)