Valuing Health at the End of Life: A Review of the Empirical Literature

Do members of the general public wish to place greater weight on a unit of health gain for end of life patients than on that for other types of patients?

On 22 September 2015, OHE’s Koonal Shah gave a seminar at the Institute of Health Policy & Management, Erasmus University Rotterdam. Koonal’s presentation reported research conducted in collaboration with Professors Aki Tsuchiya and Allan Wailoo of the University of Sheffield. 

The National Institute for Health and Care Excellence (NICE) has, since 2009, issued supplementary advice to its advisory committees regarding the appraisal of life-extending end of life treatments. This includes an option for recommending such treatments for use in the NHS if certain criteria are met, even if their base case cost-effectiveness estimates exceed the range usually considered acceptable. 

NICE’s policy thus places additional weight on the survival benefits for patients with short life expectancy. It is unclear whether this reflects the preferences of the general public. 

In his presentation, Koonal reported the methods and preliminary results of a review of the published literature relevant to the following research question: Do members of the general public wish to place greater weight on a unit of health gain for end of life patients than on that for other types of patients?

The primary finding of the review is that the existing evidence is mixed, with an equal split between the number of studies that report evidence consistent with a ‘premium’ for end of life treatments and the number of studies that do not.

Access Koonal’s presentation below.

Related publications include:

Shah, K.K., Tsuchiya, A. and Wailoo, A.J., 2015. Valuing health at the end of life: A stated preference discrete choice experiment. Social Science & Medicine, 124, pp.48-56. [available to download free-of-charge]

Shah, K.K., Tsuchiya, A. and Wailoo, A.J., 2014. Valuing health at the end of life: an empirical study of public preferences. European Journal of Health Economics, 15(4), pp.389-399. [available here]

Shah, K., Chapman, A., Devlin, N. and Barnsley, P., 2015. Do respondents completing abstract, hypothetical priority-setting exercises agree with the policy implications of their choices? Consulting Report. London: Office of Health Economics. [available to download free-of-charge] 

For more information on OHE’s research in this area, please contact Koonal Shah.