“Discount rate” is an economic term which refers to an increase in value required to compensate for a delay.  For example, if I were indifferent between $500 now and $1000 a year from now, then my annual discount rate would be 100%, because $1000 represents a 100% increase in the $500 over the course of the year.  To illustrate the applicability of this concept to medicine, consider these two questions based on research by Chapman (1996):

Question 1

Suppose you had won a lottery.  You may choose between two monetary prizes.  You can receive either $500 right now or ________ one year from now.  Select the number which would make you indifferent between the immediate $500 prize and the delayed prize.

$750       $1000       $1500

Question 2

You need to take medication . . . once a day.  You must also be very careful about what foods you eat, so you spend a lot of time keeping track of what you eat.  You find it necessary to visit the bathroom quite often to urinate.

You often feel tired and sometimes feel light-headed.  You sometimes have trouble falling asleep and sometimes have nightmares when you do sleep.  Your mouth sometimes feels dry, and foods do not seem to have as much taste as they used to.  You don’t have as much desire for sex as you used to, and you do not find sex an enjoyable as you used to.  You often feel angry or irritated, and it is difficult to concentrate.

You may choose between two treatments.

Treatment A would return you to full health for 1 year and would take effect today.

Treatment B would return you to full health for _______ years; however, the treatment would not take effect until 1 year from today.

Select the number that would make you indifferent between the immediate health improvement and the delayed one.

2 Years      3 Years       4 Years

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