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L'indicateur QALYs à la lumière de la théorie de l'utilité espérée multi-attribut explicitement décomposée

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  • Anne-Marie Fericelli
  • Catherine Le Galès
  • Catherine Buron
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    Abstract

    [eng] An Explanatory Analysis of the QALYs Indicator in the Light of Multi- Attribute Utility Theory by Catherine Buron, Catherine Le Gales and Anne-Marie Fericelli . For the past few years a number of health microeconomists have been suggesting that quality adjusted life years (QALYs) should be included in economic analysis. The first half of the paper offers a critical review of existing QALYs models in the light of Keeney and Raiffa's multi-attribute utility theory (MUT). In the second half, the conditions for QALYs modelling with this theory are explained and the various hypotheses (independence in terms of utility, mutual utility and additive utility) are stated and then discussed. Whilst highlighting the lack of evidence for the empirical validity of the hypotheses required for QALYs modelling consistent with the MUT, the survey demonstrates the importance of the MUT for modelling utility functions relating to chronic states of health. [fre] L'indicateur QALYs à la lumière de la théorie de l'utilité espérée multi-attribut explicitement décomposée par Catherine Buron, Catherine Le Gales et Anne-Marie Fericelli . Depuis plusieurs années, certains micro-économistes de la santé ont proposé d'intégrer dans la démarche du calcul économique, le calcul d'un nombre d'années de vie ajusté par la qualité (QALYs). Cet article a pour objectif de procéder, dans une première partie, à une revue critique des modélisations QALYs existantes, à la lumière de la théorie de l'utilité multi-attribut (TUM) de Keeney et Raiffa. Dans une seconde partie, les conditions d'une modélisation du QALY par cette théorie sont explicitées et les différentes hypothèses (indépendance en termes d'utilité, d'utilité mutuelle et d'utilité additive) sont présentées puis discutées. Si cette revue souligne l'insuffisance de preuves quant à la validité empirique des hypothèses nécessaires à une modlisation QALYs cohérente avec la TUM, en revanche, elle éclaire l'intérêt de la TUM pour modéliser des fonctions d'utilité pour des états de santé chroniques.

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    Bibliographic Info

    Article provided by Programme National Persée in its journal Économie & prévision.

    Volume (Year): 129 (1997)
    Issue (Month): 3 ()
    Pages: 55-71

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    Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5864

    Note: DOI:10.3406/ecop.1997.5864
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    Web page: http://www.persee.fr/web/revues/home/prescript/revue/ecop

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    1. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
    2. Lowenstein, George & Prelec, Drazen, 1991. "Negative Time Preference," American Economic Review, American Economic Association, vol. 81(2), pages 347-52, May.
    3. Gafni, Amiram & Birch, Stephen & Mehrez, Abraham, 1993. "Economics, health and health economics: HYEs versus QALYs," Journal of Health Economics, Elsevier, vol. 12(3), pages 325-339, October.
    4. A Mehrez & A Gafni, 1991. "Healthy Years Equivalent: How to Measure Them Using the Standard Gamble Approach," Centre for Health Economics and Policy Analysis Working Paper Series 22, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    5. Scott F. Richard, 1975. "Multivariate Risk Aversion, Utility Independence and Separable Utility Functions," Management Science, INFORMS, vol. 22(1), pages 12-21, September.
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