Both the “preference” and “those affected” aspects are important. Their ethical relevance lies in their reflecting the preferences of those whose health is directly affected by the allocation of health care resources that a given threshold guides. To engage in the ethical debate about the current threshold value for a WTP/QALY ratio, or the willingness to pay for a QALY gained, and the importance of updating it, a clear understanding of the essential functions and nature of both WTP and QALY is required. How the WTPs should be updated is, however, unclear to task force members as they begin to deliberate. One health care organization’s executive, Dr CXO, has suggested, “Given how insurers and other third-party payers in the US health care system rely on population-based WTP thresholds to guide decisions, we should probably be leerier of using estimates that are so old.”ĭr CXO continued, “If a patient or that patient’s physician, for example, asked me why we’ve been using decades-old value estimates to determine, say, what a patient’s additional quality-adjusted life-year (QALY) might be worth, I don’t think I’d be able to come up with a very convincing answer.”ĭr CXO then assembled a long-term task force charged with updating the WTPs the organization uses, particularly as they relate to QALYs. 1 In the United States, a WTP threshold of $50 000 to $100 000 is still referenced and used today by public and private policymakers, insurers, and researchers, for example, despite having been established in 1982. CaseĪ willingness-to-pay (WTP) threshold, according to the World Health Organization (WHO), is a value used to represent “an estimate of what a consumer of health care might be prepared to pay for the health benefit” and is often based on a country’s per capita gross domestic product. Although updating WTP thresholds might be better than not updating them, this manuscript suggests why drawing on a less fundamentally flawed concept than the conventional QALY is more important. Because the value of simply being alive is not adequately accounted for, how life extension and quality improvement are combined in constructing the QALY is its most significant shortcoming as a measure. For QALYs, that justification depends on eliciting the right persons’ preferences to inform quality-adjustment ratings on balance it should be from those who have the conditions being rated. For WTP thresholds, such justification depends on the sufficiency of a match between a group-members of an insurance pool from which health care payments and services are drawn-and those whose health care is potentially affected. Ethical justification for using WTP thresholds and QALYs lies in incorporating the preferences of those whose treatment could be affected by resulting resource allocations. It was also found that by adding 0.96% garlic powder it is possible to reduce the sodium content from 0.827% to 0.3707% and improve the sensory acceptance of the product.Before updating any willingness-to-pay (WTP) per quality-adjusted life-year (QALY) threshold, a few points must be recognized. In addition, a new sensory threshold is proposed, the favored acceptance threshold (FAT), defined as the stimulus intensity at which significant improvement in sensory acceptance of the product begins to occur. It was found that by adding 0.96% garlic powder only to reduce the hamburger sodium concentration from 0.827% to 0.2504%, sensory acceptance of the product began to deteriorate and when adding 0.9907% garlic powder, only for reducing the sodium content from 0.827% to 0.1319%, sensory rejection of the hamburger begins to occur. For this purpose, the central composite rotatable design was used, with response surface graphs, obtaining the equations that allow for calculating the different intensity combinations of the two stimuli that result in the beginning of compromised acceptance (CAT) and the beginning of sensory rejection (HRT) of the product. The objective of this study was to propose a new methodology, the Hedonic Thresholds Methodology Varying Two Stimuli (HTM₂ₛ), which allows for determining the compromised acceptance threshold and the hedonic rejection threshold by simultaneously varying the intensities of two stimuli in a food. However, at present it is only possible to determine sensory thresholds by varying just one stimulus at a time. 104003 ISSN: 0950-3293 Subject: food quality, garlic, methodology, sodium Abstract: In several situations it is desired to simultaneously alter the intensities of two food stimuli without affecting acceptance or causing sensory rejection.
![hedonic threshold hedonic threshold](https://image4.slideserve.com/1062082/main-results-l.jpg)
The hedonic thresholds methodology varying two stimuli: Extending the range of sensory threshold applications Author: Tarcísio Lima Filho, Louise Bergamin Athayde de Souza, Suzana Maria Della Lucia, Luis Antônio Minim, Valéria Paula Rodrigues Minim Source: Food quality and preference 2020 v.86 pp.