A comparison of welfarist and extra welfarist approaches to valuing outcomes in menorrhagia

Sanghera, Sabina (2014). A comparison of welfarist and extra welfarist approaches to valuing outcomes in menorrhagia. University of Birmingham. Ph.D.

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Extra-welfarist measures are recommended, by decision-makers, for use in economic evaluations. Hence they are commonly used to value outcomes in chronic conditions with episodic symptoms, such as menorrhagia. In menorrhagia, a woman’s perceived change in quality-of-life (QoL) is the measure of treatment success and consequently, the primary clinical and economic outcome is change in QoL. This thesis presents findings of a comparison between welfarist and extra-welfarist approaches to valuing outcomes in menorrhagia, and aims to determine the value of levonorgestrel-releasing intrauterine system (LNG-IUS) compared to usual medical treatment for menorrhagia.

Findings from the systematic review demonstrated concerns that extra-welfarist measures may be unsuitable in menorrhagia due to their narrow health-related focus and that results depend on the timing of assessment, given the condition’s episodic nature. The economic evaluation alongside the ECLIPSE trial showed that the extra-welfarist measures, EQ-5D and SF-6D, provide contrasting cost-effectiveness decisions. The welfarist willingness-to-pay (WTP) was shown to capture important aspects of wellbeing that are not captured by these extra-welfarist measures. Similar to SF-6D, the economic evaluation using WTP presented evidence against the use of the decision-maker recommended EQ-5D. It is argued that each measure provides information that should be considered by decision-makers when allocating healthcare resources.

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Health and Population Sciences, Health Economics Unit
Funders: None/not applicable
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > R Medicine (General)
R Medicine > RG Gynecology and obstetrics
URI: http://etheses.bham.ac.uk/id/eprint/4831


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