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Respondent explanation



As both patients will suffer from severe anxiety depression, no preference

Avoid severe anxiety/depression

The difference between the two seems inconsequential

Avoid severe anxiety/depression at the prime of P's life: more of a burden than death

Fair innings



Because treating them will result in 2 more years of life at same quality as patient P

Because treating them results in longer life at same quality as P's life

Because at point of treatment, outcome is the same

Because Q gets most years of life at higher quality of life

Treating patient P gets more years of life in full health



More life years gained

Give treatment to the one who would have poorer health without it

Give treatment to the one who has had poorer lifetime health experience

Fair innings

Fair innings



More life years

Patient P's life without treatment will be worse than patient Q's without treatment

Both in same health state before - they probably have mechanisms to cope with the situation

Patient P has already had a good 60 yrs of full health

Younger person may be more productive, and also have young children to care for



More chance to live longer in the same health state

He suffers more than patient Q

Both have same chance of health state C for 10 years

Too young to die

Patient Q is too young to die



The difference between states B and C doesn't seem too big to enjoy normal life and work

Even without treatment, Q can enjoy reasonable standard of health

Treating patient P leads to cost-saving, as patient P requires other care givers

Treatment cost for more severe condition would be more expensive

The individual can contribute to wealth creation for longer time than patient Q



A balance of worse pre-treatment health state and higher post-treatment life years

Because without treatment Patient P is in a worse situation

Because patient Q has been more time in state E

He is very young, so it's fair to give him 20 more years than a person who has lived for 60 years

Because he's younger than patient P and the difference between years gained is only five years



I could not say that patient P's/Q's life is more or less worthy than vice versa

The only scenario in which I would consider choosing one over the other

is if I had to choose between saving a child's life and prolonging the life of a very old

person in an extremely bad health state [This respondent used the same comment for all of the questions]





S/he stands to benefit more in terms of longer life after treatment

S/he stands to benefit more in terms of longer life after treatment

Each patient has equal benefit after treatment

P is younger - society can also benefit more from him

Within the working/active life age, society can benefit more from him than from P



Patients and outcomes are too similar to choose between the patients on the basis of available information

Outcome is better for patient Q - therefore, better value for money (increase QoL)

Patient Q has had poorer lifetime health up to age 65

Trade-off between better QoL outcome for patient Q is difficult to make against 'fair innings' for patient P

Patient Q has had a lower life opportunity, despite slightly shorter benefit derived from the intervention



Regardless of the 2 years for Q, I couldn't justify picking him on such a small difference in treatment outcome

The non-treatment route for Q is less severe than that for P

The outcomes are the same at the point of treatment

Patient P is severely depressed which is not a good life, but is too young to die

Best outcome overall: 2 people live into their 50s in full health



Should have an equal chance

Severe childhood depression has profound non-health consequences in adulthood

No difference in benefits to individuals

Will not discriminate - life is precious and should be valued equally

Will not discriminate between the two - value of life is sacrosanct



We better give 'more life' to the one who had worse life before 25. 50-52 yrs is not a big difference

74-75 is an ok age to die

Since he didn't have full health, we can compensate by giving him some better health at the end of life

I'd rather have both patients live up to 40 and 60 rather than 20 and 85

I'd rather have both alive up to age 50-55 and enjoy their family



Allocating resources to Q gives more life years than P

I get more life years in treating Q than P

Prioritise the patient who is least likely to be aclimatised to health state E

Q's health state is much better than P's following treatment

After allocating resources, P has a further 30 yrs to Q's 25



Extra 2 yrs for Q not enough to sway decision. Health state C not depressed enough relative to B to choose P

If P does not receive treatment, he will live a shorter life than Q and in a poor health state

After age 65, they will live exactly the same life

Valuation based on trade off between years lived, years gained, and quality of life

Treatment for patient Q brings life up to approximate parity with P



Although Q has more life years to gain, from his perspective they'll be lower quality relative to patient P

Patient P has more to lose from foregoing treatment

Patient Q's been in poorer health all his life

I could justify this choice to patient Q

Equality/fair innings. I'm sure patient P would agree with my decision



P is starting out in a worse health state and would be more likely to benefit less from an extension of life in D

Too difficult to choose between 8 year olds for lifelong poor health states

An improvement in health at such an elderly age would be great but is not natural/realistic

Would want to extend the young person's life, but could extend the older person's life and lower the quality less

Both are fairly young and have good reason to live - e.g. have a family at 50 and start one at 30

P had a worse first 25 years, and may enjoy post treatment life more as he moves only one state down

In this scenario my mind only considered the quality of life gained from treatment

Q suffered more until treatment was available

I couldn't ignore that someone should die at age 20 by giving treatment to someone who already had 60 years

Priority to the younger person



I have the opportunity to give 17 additional years

Without treatment, P's quality of life will be low. Policy maker has to ensure minimum QoL

Patient Q has never lived in full health, and could experience a large improvement in overall QoL

Patient P needs support to enlarge his life, even though his QoL is not favourable

Q is younger and has the opportunity to live the most productive years. It is more tragic to die at 30 than 50



Patient P is more deserving of the two. Also, not much difference between states C and D

Gains more from treatment and suffers more severe disease without treatment

More deserving as Q has never lived in full health

Treat younger patient

Patient Q is younger but patient P lives longer after treatment



The treatment for patient Q will gain 2 more years of life

Patient P with treatment will gain more marginal utility than patient Q

P and Q are at the same health states, so choose randomly

Only because patient P is very young

Patient Q is young



Patient Q is healthier to start with, and will benefit more in terms of LYG

Patient Q benefits more from treatment in terms of LYG

Patient P has more years of healthy life - treating him could be more beneficial as overall costs may be reduced

Patient Q is in better health overall, and after treatment is in rather good shape too

Both could be at points in their life when they need this treatment most



Not much difference between health states, ages and life-years gained

P's case is more severe - worse health state and less time to live

Q had worse health all his life. Try to make up for some of it

For Q, quite reasonable. P's case is more severe

It's way to soon to die if you're only 30 years old



Since patient Q is already in B, the treatment will mean much more to P

The loss to P is greater without treatment, and they die at similar ages if P is treated

Patient P has lived in better health for more years

Q has already lived in full health for 60 years and it is fair to give a chance to the younger patient

P has already lived 20 more years than Q and therefore its fair to treat Q



Q would have dropped further and will have a harder time adjusting, but will live 2 years longer

Without treatment, Q lives an ok quality of life, whereas P's is greatly diminished

Patient P will benefit from treatment, but so will patient Q

P is young whereas Q has had a longer shot at life

One is younger but the other will gain more



Q remembers how it feels to be relatively healthy, and may struggle to retain happiness after treatment

Health in C seems more manageable than D and E. Similar age of death for treated P and untreated Q

Both have same post-treatment health, so I allocate for bad reasons. Q has been sicker for longer

Grant the opportunity for a full life

With treatment, Q then may be able to reproduce and live a fuller life



2 extra years gained

The loss in QoL for P outweighs the extra years gained for Q

Both have same outcomes with respect to QoL and LYG

Treating the younger patient seems a fairer use of resources

Lives longer in full health



Q was in better health throughout life

He will be worse off than patient Q if there is no treatment

At that point in both patients lives, and after so many years of ill health, can be random

Would rather provide for someone who can be in A/B than in C/D

It is preferable to keep people alive for as long as possible in full health



Despite the 2 year difference in LYG, only difference is health status. Post-treatment health status doesn't differ

The extra life years for Q don't justify the lower health for P. By selecting P, no one's status is below C

Treatment will not restore either patient to full health or grant added years to one or the other

Because treatment gives more years at better quality

More quality life years



The extra 2 years for Q offsets the equity consideration (that P deserves it because of lower initial health)

The difference between treatment and no treatment is greatest for P

Patient P had longer in better health. Patient Q deserves the increased health state

Greater gain in life years for Q and better quality years (which is also better for society)

Patient Q deserves a decent life span



Patient Q has 2 additional years of life when treated

Without treatment, P will be in D and E, which is more severe than C for Q

Both benefit almost equally from treatment

Young should be given opportunity to live, even if in poor health. At 60, won't contribute much to the economy

With treatment, Q gives extra 25 years of economic benefit to the country which P will be too old to give



Can't make up my mind between compensating P or choosing Q because he lives longer

I think not treating P would be more evil than not treating Q

Has already spent a lot of time in B and E

Q will benefit more, and will be able to appreciate a longer life

Patient Q would miss out on way too much



Longer life

After treatment, Q has longer life

Allow Q time in better health state

Treatment allows 25 years in the better health state

Longer life after the treatment



Larger fall in health status of patient Q, even though 2 extra years can be achieved

Although P has less life expectancy with treatment, will experience higher net gain in health status

Both derive the same health status with treatment

Value years gained at a younger age greater than later in life, even if QoL is not the same

Although Q will gain 5 fewer years, he will gain them earlier in life. I value gained years more in younger patients



More effective treatment

P's treatment seems better - without it his health would be far worse than Q's

Too hard to decide

I would prefer to extend the life of the younger patient

I would prefer to to extend the life of the younger person, given that treatment effect is about the same



Has the chance to live a longer life

Without treatment, Q would be better off, and if I save P, Q will live one year longer

Both patients would then have an equal distribution of health

P gets fewer life years in worse health with treatment

If I save Q, P and Q die at similar ages, so I'm valuing saving younger life



They are the same age and treatment gives almost the same outcome for both

P will suffer severe health problems without treatment whereas Q won't

The treatment has the same outcome for both

Although the treatment outcome is better for Q, P is very young

Q is younger, and can be productive for 25 years. P has already enjoyed his life



About the same utility generated

More utility is generated

The treatment creates the same utility for both

P could do more with the extra years, but Q would have more utility

Younger life years are more valuable



P has been miserable for 15 yrs, but Q will get 2 more years

Without treatment, has episodes of infermity

Less time with severe problems

Longer life without problems

Longer life



Insufficient difference in QoL and longevity pre and post-treatment

QoL of C for Q isn't as bad as D/E for P over 64/65 yrs

As post-treatment outcome is the same, giving it to Q seems to be a redressing mechanism

P ought to get it for a fair innings, but Q benefits more

Q ought to get it for a fair innings, but P benefits more



Patient Q requires less health care resources, and has higher QoL before treatment

Without treatment, Q will require costly care. State C for Q is not great, but he can take care of himself

Treatment will allow both patients to return to state C

Patient Q will have better QoL and will be less burdensome and more productive

Both time periods - 30-55 and 50-80 - are economically and socially significant



Patient Q will live longer with similar health

Q will live for longer years

After treatment both will live for another 10 years with same disabilities

P is younger and will live 20 more years if treated. Q has reached almost end of life

Patient Q is younger and will be able to contribute more to the family and society



P deserves it more as he's been in a worse situation in the past

Without treatment, P will suffer more

They will both get the same treatment benefit, but Q has suffered more in the past

Although P is younger, the treatment will give him 40 years of bad health

Both will live more or less the same years, both in full health

P has lived in a poorer health state until 25, so can accept his health deterioration in a better way

I'd treat P because the treatment period is less but the health state is the same

Because he has experienced more problems throughout his life

It'd be better to treat an old person who's lived a healthy life than to see a young person gradually die

I'd choose Q because the treatment would be 5 years less



Both will be in D for roughly the same amount of time

Without treatment, P would suffer worse health states (D/E) than Q (C) over the same period

To equalise the amount of time each patient is in E

Treatment would be of greater benefit to the overall lifetime health of P than that of Q

Little difference in number of LYG. I don't think it's justified to prioritise according to age



Patient Q will gain two more years than P at the same quality

Because Q will gain 5 more years in A which s/he can use to benefit society

We should give to Q as he has lived life in a lower health state, so it will give him more satisfaction

Q will gain more years at higher quality health

At younger years, Q will produce more benefit for society. We should also prefer Q on the basis of humanity



Neither patient either before or after treatment will be a great asset to society

More of a difference for P. Q lives adequate life without treatment

Both treatments have same results. Policy making requires one to look to the future

It's good to prolong a short life, but P has little to gain - little value for society

50 yrs for P is substantial. Allowing Q to live at 30 for 25 years gives good return to society



Q lives longer at the same quality of life

Patient P would seem to have greater benefit from treatment

Patient Q will come back closest to initial state of health with treatment

Depends on how you value different ages

Depends on how much one valued certain ages of life



Because Q hasn't consumed much treatment in the first 25 years

Q, because he would need minimal health care resources if he died in state A

Because P would have consumed fewer resources earlier in life

Q would consume fewer resources and would be more productive

P would have more productive years ahead, without requiring additional treatments



Q has better health state (B) than P (C), and is therefore more productive

Patient P without treatment is less productive and enjoys life less than patient Q without treatment

Health state after treatment is the same

We need young people to be helpful to society

I prefer to give opportunity to live to young people, and a 30 year old is more productive than at 60/70



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