Racial and ethnic differences in preferences for health states and the implications for cost–utility analysis

Abstract

Aims: Cost–utility analysis is an economic evaluation technique that takes into consideration individual preferences for health outcomes. It is crucial to determine whether racial and ethnic groups differ in preferences for health states because then we need to determine which group’s utility score should be used to conduct a cost–utility analysis that yields equitable results to all members of society. Methods: A PubMed search was conducted to identify the relevant studies. Results: There exists a potential to either undervalue or overvalue health states along racial and ethnic lines when population-based utility scores are used for clinical or policy decision-making. Some argue that if systematic racial and ethnic differences exist, then race/ethnicity-specific measures should be incorporated in the economic evaluations, at least for interventions targeted at the prevention and treatment of diseases which disproportionately affect minorities. Yet, others believe that there are troubling social and ethical implications to using subgroup health preferences as they also have the potential to disadvantage minorities. Conclusions: Attention is required for the equity issues related to the utilizations of cost–utility analysis.

Keywords::

• cost–utility analysis
• disparities
• ethnicity
• health state
• preference
• race
• race/ethnicity-specific measure
• utility score

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.