Holistic preferences for 1-year health profiles describing fluctuations in health: the case of chronic obstructive pulmonary disease

Pharmacoeconomics. 2009;27(6):465-77. doi: 10.2165/00019053-200927060-00003.


Background: There are few empirical studies on the valuation of health profiles that describe the short-term fluctuations of chronic diseases.

Objective: This study aimed to value chronic obstructive pulmonary disease (COPD) health profiles, which describe the health of these patients over the course of 1 year from a societal perspective.

Methods: We developed 16 COPD health profiles. Each profile combined a description of the severity of COPD during the stable phase with a description of the exacerbation profile in terms of severity, frequency and duration. These profiles were valued by a representative sample of 239 Dutch adults using the visual analogue scale (VAS) and time trade-off (TTO) methods. Value functions were estimated using random effects regression analysis.

Results: Both VAS and TTO values consistently decreased as severity of the COPD profiles increased. Estimated TTO values ranged from 0.97 for mild COPD without exacerbations to 0.43 for very severe COPD with one non-serious and one serious exacerbation per year. The estimated decrements in TTO values ranged from 0.010 for having one non-serious exacerbation to 0.088 for having one non-serious plus one serious exacerbation per year.

Conclusions: The value function may be an alternative way to model the joint impact of COPD severity and exacerbations on utility values in health economic modelling studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Controlled Clinical Trials as Topic
  • Cost of Illness*
  • Female
  • Holistic Health*
  • Humans
  • Male
  • Middle Aged
  • Models, Economic
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Quality of Life
  • Severity of Illness Index
  • Time Factors