Happy with Your Capabilities?

__Background__ The ICECAP-O and the ICECAP-A are validated capability well-being instruments. To be used in economic evaluations, multidimensional instruments require weighting of the distinguished well-being states. These weights are usually obtained through ex ante preference elicitation (i.e., decision utility) but could also be based on experienced utility. __Objective__ This article describes the development of value sets for ICECAP-O and ICECAP-A based on experienced utility and compares them with current decision utility weights. __Methods__ Data from 2 cross-sectional samples corresponding to the target groups of ICECAP-O and ICECAP-A were used in 2 separate analyses. The utility impacts of ICECAP-O and ICECAP-A levels were assessed through regression models using a composite measure of subjective well-being as a proxy for experienced utility. The observed utility impacts were rescaled to match the 0 to 1 range of the existing value set. __Results__ The calculated experienced utility values were similar to the decision utility weights for some of the ICECAP dimensions but deviated for others. The largest differences were found for weights of the ICECAP-O dimension enjoyment and the ICECAP-A dimensions attachment and autonomy. __Conclusions_

Preferences for e-Mental Health Interventions in Germany

_Objectives:_ Recent evidence suggests that e-mental health interventions can be effective at improving mental health but that there is still a notable hesitation among patients to use them. Previous research has revealed that they are perceived by patients as being less helpful than face-to-face psychotherapy. The reasons for this unfavorable perception are, however, not yet well understood. The aim of our study was to address this question by eliciting preferences for individual components of e-mental health interventions in a discrete choice experiment. _Methods:_ Using a stepwise qualitative approach, we developed the following 5 attributes of eMHIs: introductory training,human contact, peer support, proven effectiveness, content delivery, and price. Additionally, we asked questions about re-spondents’ demographics, attitudes, and previous experience of traditional psychotherapy, as well as their distress level. _Results:_ A total of 1984 respondents completed the survey. Using mixed logit models, we found that personal contact with a psychotherapist in blended care, proven effectiveness, and low price were highly valued by participants. Participants were indifferent toward the mode of content delivery but showed a slight preference for introductory training via phone, as well as for peer support via online forum alongside coach-led group meetings on site. _Discussion:_ Our results suggest a clear preference for blended care that includes face-to-face contact with a psychotherapist. This preference remained stable irrespective of sociodemographics, previous experience of psychotherapy, distress level, and the 2 context scenarios used in our discrete choice experiment. Further investigations looking at the potential benefits and risks of blended care are needed

Estimating the monetary value of health and capability well‑being applying the well‑being valuation approach

Background: Quality of life measures going beyond health, like the ICECAP-A, are gaining importance in health technology assessment. The assessment of the monetary value of gains in this broader quality of life is needed to use these measurements in a cost-effectiveness framework. Methods: We applied the well-being valuation approach to calculate a first monetary value for capability well-being in comparison to health, derived by ICECAP-A and EQ-5D-5L, respectively. Data from an online survey administered in February 2018 to a representative sample of UK citizens aged 18–65 was used (N = 1512). To overcome the endogeneity of income, we applied an instrumental variable regression. Several alternative model specifications were calculated to test the robustness of the results. Results: The base case empirical estimate for the implied monetary value of a year in full capability well-being was £66,597. The estimate of the monetary value of a QALY, obtained from the same sample and using the same methodology amounted to £30,786, which compares well to previous estimates from the willingness to pay literature. Throughout the conducted robustness checks, the value of capability well-being was found to be between 1.7 and 2.6 times larger than the value of health. Conclusion: While the applied approach is not without limitations, the generated insights, especially concerning the relative magnitude of valuations, may be useful for decision-makers having to decide based on economic evaluations using the ICECAP-A measure or, to a lesser extent, other (capability) well-being outcome measures