IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v17y1997i4p402-408.html
   My bibliography  Save this article

Are Methods for Estimating QALYs in Cost-Effectiveness Analyses Improving?

Author

Listed:
  • Peter J. Neumann
  • Darren E. Zinner
  • Janice C. Wright

Abstract

Objectives. The objectives of this study were to examine variations in the methods used by researchers to estimate QALYs in published cost-effectiveness analyses, and to investigate whether the methods have improved over time. Data and methods. Using a MEDLINE search, the authors identified 86 original cost-effectiveness analyses, pub lished between 1975 and 1995, that used QALYs as the measure of effectiveness. For each study, they recorded the health-state classification system, the source of the preference weights, the measurement technique, and the discount rate. The methods used were compared with the recommendations of the U.S. Panel on Cost-Effective ness in Health and Medicine. Results. Only 20% of the studies used "generic" health- state classification systems (e.g., health utilities index); 21% relied on community- based weights; 40% used formal measurement techniques (e.g., time-tradeoff method); and 88% discounted both future costs and QALYs. There was little evidence that methods had improved over time. Conclusions. The results illustrate extensive variation in the construction of QALYs in cost-effectiveness analyses and reveal that most studies have not adhered to practices now recommended by leaders in the field. There is a need for more methodologic rigor and consistency if the results of such studies are to be compared and used for purposes of allocating resources. Key words: QALYs; quality-adjusted; cost-effectiveness analysis. (Med Decis Making 1997;17: 402-408)

Suggested Citation

  • Peter J. Neumann & Darren E. Zinner & Janice C. Wright, 1997. "Are Methods for Estimating QALYs in Cost-Effectiveness Analyses Improving?," Medical Decision Making, , vol. 17(4), pages 402-408, October.
    • Handle: RePEc:sae:medema:v:17:y:1997:i:4:p:402-408
    DOI: 10.1177/0272989X9701700405
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X9701700405
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X9701700405?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Drummond, Michael & Torrance, George & Mason, James, 1993. "Cost-effectiveness league tables: More harm than good?," Social Science & Medicine, Elsevier, vol. 37(1), pages 33-40, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Linda D. MacKeigan & Amiram Gafni & Bernie J. O'Brien, 2003. "Double discounting of QALYs," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 165-169, February.
    2. Gerard, Karen & Smoker, Irenie & Seymour, Janelle, 1999. "Raising the quality of cost-utility analyses: lessons learnt and still to learn," Health Policy, Elsevier, vol. 46(3), pages 217-238, March.
    3. Trude Arnesen & Mari Trommald, 2005. "Are QALYs based on time trade‐off comparable? – A systematic review of TTO methodologies," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 39-53, January.
    4. K. Cooper & S. Brailsford & R. Davies & J. Raftery, 2006. "A review of health care models for coronary heart disease interventions," Health Care Management Science, Springer, vol. 9(4), pages 311-324, November.
    5. K Cooper & S C Brailsford & R Davies, 2007. "Choice of modelling technique for evaluating health care interventions," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 168-176, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tappenden, P & Brazier, J & Ratcliffe, J, 2006. "Does the National Institute for Health and Clinical Excellence take account of factors such as uncertainty and equity as well as incremental cost-effectiveness in commissioning health care services? A," MPRA Paper 29772, University Library of Munich, Germany.
    2. Rutten, Frans, 1996. "Economic evaluation and health care decision-making," Health Policy, Elsevier, vol. 36(3), pages 215-229, June.
    3. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    4. Wolfgang C. Winkelmayer & Milton C. Weinstein & Murray A. Mittleman & Robert J. Glynn & Joseph S. Pliskin, 2002. "Health Economic Evaluations: The Special Case of End-Stage Renal Disease Treatment," Medical Decision Making, , vol. 22(5), pages 417-430, October.
    5. Cookson, Richard & Hutton, John, 2003. "Regulating the economic evaluation of pharmaceuticals and medical devices: a European perspective," Health Policy, Elsevier, vol. 63(2), pages 167-178, February.
    6. Tom Jefferson & Miranda Mugford & Alastair Gray & Vittorio Demicheli, 1996. "An exercise on the feasibility of carrying out secondary economic analyses," Health Economics, John Wiley & Sons, Ltd., vol. 5(2), pages 155-165, March.
    7. Lindholm, Lars & Rosen, Mans & Emmelin, Maria, 1996. "An epidemiological approach towards measuring the trade-off between equity and efficiency in health policy," Health Policy, Elsevier, vol. 35(3), pages 205-216, March.
    8. Joakim Ramsberg, 2002. "When should expenditure per life saved vary?," Journal of Risk Research, Taylor & Francis Journals, vol. 5(3), pages 249-263, July.
    9. Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    10. Gafni, Amiram & Birch, Stephen, 2006. "Incremental cost-effectiveness ratios (ICERs): The silence of the lambda," Social Science & Medicine, Elsevier, vol. 62(9), pages 2091-2100, May.
    11. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    12. Drummond, Michael & Mason, James & Torrance, George, 1995. "Cost-effectiveness league tables: think of the fans," Health Policy, Elsevier, vol. 31(3), pages 231-238, March.
    13. Debby Postulart & Eddy M.M. Adang, 2000. "Response Shift and Adaptation in Chronically III Patients," Medical Decision Making, , vol. 20(2), pages 186-193, April.
    14. James Mason & Mike Drummond, 1995. "The DH register of cost-effectiveness studies: a review of study content and quality," Working Papers 128chedp, Centre for Health Economics, University of York.
    15. Samuel Shillcutt & Damian Walker & Catherine Goodman & Anne Mills, 2009. "Cost Effectiveness in Low- and Middle-Income Countries," PharmacoEconomics, Springer, vol. 27(11), pages 903-917, November.
    16. Richard H. Chapman & Patricia W. Stone & Eileen A. Sandberg & Chaim Bell & Peter J. Neumann, 2000. "A Comprehensive League Table of Cost-Utility Ratios and a Sub-table of "Panel-worthy" Studies," Medical Decision Making, , vol. 20(4), pages 451-458, October.
    17. Andrew R. Willan & Bernie J. O'Brien, 1996. "Confidence intervals for cost‐effectiveness ratios: An application of Fieller's theorem," Health Economics, John Wiley & Sons, Ltd., vol. 5(4), pages 297-305, July.
    18. A. David Paltiel & Julie A. Scharfstein & George R. Seage & Elena Losina & Sue J. Goldie & Milton C. Weinstein & Donald E. Craven & Kenneth A. Freedberg, 1998. "A Monte Carlo Simulation of Advanced HIV Disease," Medical Decision Making, , vol. 18(2_suppl), pages 93-105, April.
    19. Phusit Prakongsai & Natasha Palmer & Preecha Uay-Trakul & Viroj Tangcharoensathien & Anne Mills, 2009. "The implications of benefit package design: the impact on poor Thai households of excluding renal replacement therapy," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 291-308.
    20. Ann E. Clarke, 1997. "Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy," Canadian Public Policy, University of Toronto Press, vol. 23(s1), pages 162-176, Spring.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:17:y:1997:i:4:p:402-408. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.