Experience-based utility and own health state valuation: why do it and how to do it

J Brazier, D Rowen, M Karimi, T Peasgood, A Tsuchiya, J Ratcliffe


In the estimation of population value sets for measures such as the EQ-5D, there is increasing interest in asking respondents to value their own health state, sometimes referred to as “experience-based utility values”, rather than hypothetical health states. Evidence shows that these experience-based utility values differ to hypothetical health state values. This may be attributed to many reasons. This paper first critically examines: why this difference is important, whether own visual analogue scale (VAS) or time trade-off (TTO) really measure experience-based utility values, the biases from current methods of collecting experience-based utility data, and the modelling of the data. Second, the paper reviews some of the normative arguments for and against using own health state valuation. Finally, the paper also examines other ways own health state values can be taken into account, such as including the use of informed general population preferences that may better take into account experience-based values.