HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Thursday, 6 December 2012

DSU report on societal preferences for end of life

The NICE Supplementary Guidance (2009) specifies conditions under which 'end of life' treatments may be given higher priority than other health care interventions. This project seeks to examine whether a social preference exists for giving higher priority to life-extending, end of life treatments than to other treatments, using preference data elicited from the general public.

NICE commissioned the DSU to undertake two studies: (i) a small scale 'preference validation' study designed to develop a better understanding of the reasons and principles underpinning people's priority setting preferences; and (ii) a large scale discrete choice experiment designed to provide a thorough and robust investigation of the preferences of a representative sample of the general public.

A literature review, the validation study and associated presentations have been previously published on the DSU web site.  The results of the main DCE are now available, in full or as a summary.  The key findings are:
  • There is no evidence that respondents on average are willing to sacrifice aggregate health gains in order to give priority to the treatment of end of life patients.
  • Most respondents choose to treat the patient who is closest to their end of life only when the benefits of treating that patient (in terms of QALYs gained) are similar to or greater than the benefits of treating the non-end of life patient.
  • Whilst both types of gain appear to be important, the results from the regression analysis suggest that life-extending treatments are valued more highly than quality of life-improving treatments that offer similar gains in terms of QALYs.
  • All else being equal, respondents are more likely to choose to treat a patient who has just found out about their illness than one who has known about their illness for some time.