Qaly maximisation and people's preferences

A methodological review of the literature

Datos Bibliográficos

ID23360558
AutoresPaul Dolan (0000-0001-6180-2849, University of Oslo, autor de correspondencia), Paul J Dolan (0000-0001-9068-1484), Rebecca Shaw (0000-0002-1190-7244, University of York), Akiko Tsuchiya (0000-0003-4245-5399, University of Sheffield), Aki Tsuchiya, Alan Williams (0000-0003-2032-1875, University of York)
Año2005
Volumen14
Número2
Páginas197-208
Fecha de publicación2005-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Economics (JOURNAL)
Identificadores de la revistaISSN: 1057-9230 • E-ISSN: 1099-1050
EditorialWiley (PUBLISHER • GB)
DOI10.1002/hec.924
PMID15386656
OpenAlexW2038273794
IdiomaEN
Citas recibidas63
Referencias citadas72

In cost‐utility analysis, the numbers of quality‐adjusted life years (QALYs) gained are aggregated according to the sum‐ranking (or QALY maximisation) rule. This requires that the social value from health improvements is a simple product of gains in quality of life, length of life and the number of persons treated. The results from a systematic review of the literature suggest that QALY maximisation is descriptively flawed. Rather than being linear in quality and length of life, it would seem that social value diminishes in marginal increments of both. And rather than being neutral to the characteristics of people other than their propensity to generate QALYs, the social value of a health improvement seems to be higher if the person has worse lifetime health prospects and higher if that person has dependents. In addition, there is a desire to reduce inequalities in health. However, there are some uncertainties surrounding the results, particularly in relation to what might be affecting the responses, and there is the need for more studies of the general public that attempt to highlight the relative importance of various key factors. Copyright © 2004 John Wiley & Sons, Ltd.

Actuarial science · Cost effectiveness · Economics · Inequality · Marginal utility · Microeconomics · Operations management · Product (mathematics) · Quality (philosophy) · Quality of life (healthcare) · Quality-adjusted life year · Ranking (information retrieval) · Statistics · Value (mathematics) · Value of life · Computer Science · Economic and Environmental Valuation · Global Health Care Issues · Health Systems, Economic Evaluations, Quality of Life · Mathematics · Medicine