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Valuing QALYs at the end of life

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  • Pinto-Prades, Jose-Luis
  • Sánchez-Martínez, Fernando-Ignacio
  • Corbacho, Belen
  • Baker, Rachel

Abstract

The possibility of weighting QALYs differently for different groups of patients has been a source of debate. Most recently, this debate has been extended to the relative value of QALYs at the end of life (EoL). The objective of this study is to provide evidence of societal preferences in relation to this topic. Three cross-sectional surveys were conducted amongst Spanish general population (n = 813). Survey 1 compared increases in life expectancy for EoL patients with health gains from temporary health problems. Survey 2 compared health gains for temporary health problems with quality of life gains at the EoL (palliative care). Survey 3 compared increases in life expectancy with quality of life gains, both for EoL patients. Preferences were elicited using Person Trade-Off (PTO) and Willingness to pay (WTP) techniques presenting two different durations of health benefit (6 and 18 months). Health benefits, measured in QALYs, were held constant in all comparisons.

Suggested Citation

  • Pinto-Prades, Jose-Luis & Sánchez-Martínez, Fernando-Ignacio & Corbacho, Belen & Baker, Rachel, 2014. "Valuing QALYs at the end of life," Social Science & Medicine, Elsevier, vol. 113(C), pages 5-14.
    • Handle: RePEc:eee:socmed:v:113:y:2014:i:c:p:5-14
    DOI: 10.1016/j.socscimed.2014.04.039
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    2. McHugh, Neil & van Exel, Job & Mason, Helen & Godwin, Jon & Collins, Marissa & Donaldson, Cam & Baker, Rachel, 2018. "Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints," Social Science & Medicine, Elsevier, vol. 198(C), pages 61-69.
    3. Jeff Round & Mike Paulden, 2018. "Incorporating equity in economic evaluations: a multi-attribute equity state approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(4), pages 489-498, May.
    4. Herlitz, Anders & Horan, David, 2016. "Measuring needs for priority setting in healthcare planning and policy," Social Science & Medicine, Elsevier, vol. 157(C), pages 96-102.
    5. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    6. Khachapon Nimdet & Nathorn Chaiyakunapruk & Kittaya Vichansavakul & Surachat Ngorsuraches, 2015. "A Systematic Review of Studies Eliciting Willingness-to-Pay per Quality-Adjusted Life Year: Does It Justify CE Threshold?," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-16, April.
    7. S. Olofsson & U.-G. Gerdtham & L. Hultkrantz & U. Persson, 2018. "Measuring the end-of-life premium in cancer using individual ex ante willingness to pay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 807-820, July.
    8. Baker, Rachel & Mason, Helen & McHugh, Neil & Donaldson, Cam, 2021. "Public values and plurality in health priority setting: What to do when people disagree and why we should care about reasons as well as choices," Social Science & Medicine, Elsevier, vol. 277(C).
    9. McHugh, Neil & Pinto-Prades, José Luis & Baker, Rachel & Mason, Helen & Donaldson, Cam, 2020. "Exploring the relative value of end of life QALYs: Are the comparators important?," Social Science & Medicine, Elsevier, vol. 245(C).
    10. Guillem López-Casasnovas & José Luis Pinto Prades, 2022. "QALY Maximization and the Social Optimum," Hacienda Pública Española / Review of Public Economics, IEF, vol. 242(3), pages 111-127, September.
    11. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2018. "Valuing health at the end of life: A review of stated preference studies in the social sciences literature," Social Science & Medicine, Elsevier, vol. 204(C), pages 39-50.
    12. Gyrd-Hansen, Dorte, 2017. "Is there additional value attached to health gains at the end-of-life? A re-visit," DaCHE discussion papers 2017:2, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    13. Dorte Gyrd‐Hansen, 2018. "Is there additional value attached to health gains at the end of life? A revisit," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 71-75, January.
    14. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    15. Sebastian Himmler & Jannis Stöckel & Job van Exel & Werner B. F. Brouwer, 2021. "The value of health—Empirical issues when estimating the monetary value of a quality‐adjusted life year based on well‐being data," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1849-1870, August.
    16. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
    17. Hansen, Lise Desireé & Kjær, Trine, 2019. "Disentangling public preferences for health gains at end-of-life: Further evidence of no support of an end-of-life premium," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    18. Gemma Lasseter & Hareth Al-Janabi & Caroline L Trotter & Fran E Carroll & Hannah Christensen, 2018. "The views of the general public on prioritising vaccination programmes against childhood diseases: A qualitative study," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-18, June.
    19. Al-Janabi, Hareth & Wittenberg, Eve & Donaldson, Cam & Brouwer, Werner, 2022. "The relative value of carer and patient quality of life: A person trade-off (PTO) study," Social Science & Medicine, Elsevier, vol. 292(C).
    20. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2016. "An elicitation of utility for quality of life under prospect theory," Journal of Health Economics, Elsevier, vol. 48(C), pages 121-134.
    21. Sebastian Himmler & Jannis Stöckel & Job van Exel & Werner Brouwer, 2020. "The Value of Health - Empirical Issues when Estimating the Monetary Value of a QALY Based on Well-Being," SOEPpapers on Multidisciplinary Panel Data Research 1101, DIW Berlin, The German Socio-Economic Panel (SOEP).
    22. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.
    23. Arthur E. Attema & Marieke Krol & Job Exel & Werner B. F. Brouwer, 2018. "New findings from the time trade-off for income approach to elicit willingness to pay for a quality adjusted life year," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 277-291, March.
    24. Chamberlain, Charlotte & Owen-Smith, Amanda & MacKichan, Fiona & Donovan, Jenny L. & Hollingworth, William, 2019. "“What’s fair to an individual is not always fair to a population”: A qualitative study of patients and their health professionals using the Cancer Drugs Fund," Health Policy, Elsevier, vol. 123(8), pages 706-712.
    25. Koonal Shah & Aki Tsuchiya & Allan Wailoo, 2014. "Valuing health at the end of life: an empirical study of public preferences," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(4), pages 389-399, May.

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    More about this item

    Keywords

    Spain; QALY weights; End of life; Palliative care; Life extension; Willingness to pay; Person trade-off;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D6 - Microeconomics - - Welfare Economics
    • H4 - Public Economics - - Publicly Provided Goods

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