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QALY-maximisation and public preferences: results from a general population survey

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Author Info

  • Stirling Bryan

    (Health Economics Facility, University of Birmingham, UK)

  • Tracy Roberts

    (Health Economics Facility, University of Birmingham, UK)

  • Chris Heginbotham

    (East & North Hertfordshire Health Authority, UK)

  • Alison McCallum

    (Department of Primary Care & Population Sciences, Royal Free & University College London Medical School, UK)

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    Abstract

    The appropriate criteria that should be used in setting priorities in a publicly funded health care system remain open to debate. From a health economics perspective, quality-adjusted life years (QALYs) are increasingly portrayed as a measure of societal value and the criterion of QALY maximisation is then advocated. This paper reports a study that investigated the extent to which some of the assumptions underlying the QALY maximisation approach, notably constant marginal societal value for increases in the size of health programmes, the level of risk, and the level of benefit are supported by members of the public. A general population interview-based survey was conducted. The survey design employed conjoint methods. In general, the public preference data from this study, in themselves, are not much at odds with the core proportionality assumptions concerning societal value in the QALY maximisation model assumptions. The data are, however, at odds with reports from various previous studies. Copyright © 2002 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.695
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 11 (2002)
    Issue (Month): 8 ()
    Pages: 679-693

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    Handle: RePEc:wly:hlthec:v:11:y:2002:i:8:p:679-693

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
    2. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
    3. Ubel, Peter A. & Loewenstein, George, 1995. "The efficacy and equity of retransplantation: an experimental survey of public attitudes," Health Policy, Elsevier, vol. 34(2), pages 145-151, November.
    4. Vick, Sandra & Scott, Anthony, 1998. "Agency in health care. Examining patients' preferences for attributes of the doctor-patient relationship," Journal of Health Economics, Elsevier, vol. 17(5), pages 587-605, October.
    5. Carol Propper, 1988. "Estimation of the value of time spent on NHS waiting lists using stated preference metholdology," Working Papers 049chedp, Centre for Health Economics, University of York.
    6. Dolan, Paul & Cookson, Richard, 2000. "A qualitative study of the extent to which health gain matters when choosing between groups of patients," Health Policy, Elsevier, vol. 51(1), pages 19-30, February.
    7. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
    8. Mandy Ryan & Jenny Hughes, 1997. "Using Conjoint Analysis to Assess Women's Preferences for Miscarriage Management," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 261-273.
    9. Stirling Bryan & Martin Buxton & Robert Sheldon & Alison Grant, 1998. "Magnetic resonance imaging for the investigation of knee injuries: an investigation of preferences," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 595-603.
    10. Stirling Bryan & Lisa Gold & Rob Sheldon & Martin Buxton, 2000. "Preference measurement using conjoint methods: an empirical investigation of reliability," Health Economics, John Wiley & Sons, Ltd., vol. 9(5), pages 385-395.
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    Cited by:
    1. Schwappach, David L.B. & Strasmann, Thomas J., 2006. ""Quick and dirty numbers"?: The reliability of a stated-preference technique for the measurement of preferences for resource allocation," Journal of Health Economics, Elsevier, vol. 25(3), pages 432-448, May.
    2. Richard Norman & Gisselle Gallego, 2008. "Equity weights for economic evaluation: An Australian Discrete Choice Experiment, CHERE Working Paper 2008/5," Working Papers 2008/5, CHERE, University of Technology, Sydney.
    3. Colin Green & Karen Gerard, 2009. "Exploring the social value of health-care interventions: a stated preference discrete choice experiment," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 951-976.
    4. Gold, Marthe Rachel & Franks, Peter & Siegelberg, Taryn & Sofaer, Shoshanna, 2007. "Does providing cost-effectiveness information change coverage priorities for citizens acting as social decision makers?," Health Policy, Elsevier, vol. 83(1), pages 65-72, September.
    5. Girard, Dorota Zdanowska, 2005. "The cost of epidemiological transition: A study of a decrease in pertussis vaccination coverage," Health Policy, Elsevier, vol. 74(3), pages 287-303, November.

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