In cost-utility analysis utilities are used to estimate how much better the quality of life is valued in one health state compared with another. Valuations of patients are often found to be different from valuations of members of the general public. Separate research fields came up with theories to explain this discrepancy. Based on these theories Stiggelbout & De Vogel-Voogt (2008) described a framework presenting the process of health state valuation and mechanisms that play a role in this process. In the presentation I will discuss this framework and focus on some aspects through empirical data.

Data of 129 patients with rheumatoid arthritis, 64 members of the public, and 60 partners of patients with rheumatoid arthritis was collected. Using these data we found that patients give higher valuations compared to members of the public. Partners’ valuations lie in-between. Furthermore we investigated the effect of enriching a health state scenario within the patient sample. Contrary to our hypotheses only limited support was found for the contention that the EQ-5D state description might be too sparse. Finally qualitative data from patients and members of the public was used to investigate focus illusion. Members of the public appear to be focussed on life domains that are negatively influenced by being in poor health, whereas patients are focussed on life more in general. (Joint work with Prof.dr. A.M. Stiggelbout)