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QALYs, Person Trade-Offs, and the Pareto Principle

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  • Lars Peter Østerdal

    (Institute of Economics, University of Copenhagen)

Abstract

A considerable literature seems to argue the use of person trade-offs to estimate the quality-adjustment factor in Quality-Adjusted Life Years (QALY) models. A similar practise is followed by the WHO to estimate the disability weights used in calculation of Disability-Adjusted Life Years (DALY) for assessment of region- and disease-specific burden of disease. In this note we show that QALY (and DALY) models based on person trade-off scores generally violate the Pareto principle.

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Bibliographic Info

Paper provided by University of Copenhagen. Department of Economics in its series Discussion Papers with number 04-10.

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Length: 12 pages
Date of creation: Jul 2004
Date of revision:
Handle: RePEc:kud:kuiedp:0410

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Keywords: person trade-off; QALY; DALY; Pareto principle; social welfare;

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  1. José-Luis Pinto-Prades & José-Mar�a Abellán-Perpi�án, 2005. "Measuring the health of populations: the veil of ignorance approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 69-82.
  2. Peter A. Ubel & Jeff Richardson & Paul Menzel, 2000. "Societal value, the person trade-off, and the dilemma of whose values to measure for cost-effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 127-136.
  3. Eva Rodr�guez-M�guez & José-Luis Pinto-Prades, 2002. "Measuring the social importance of concentration or dispersion of individual health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 43-53.
  4. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
  5. Jose-Luis Pinto Prades, 1997. "Is the Person Trade-off a Valid Method for Allocating Health Care Resources?," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 71-81.
  6. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
  7. Paul Dolan & Aki Tsuchiya, 2003. "The person trade-off method and the transitivity principle: an example from preferences over age weighting," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 505-510.
  8. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  9. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-14, November.
  10. Ubel, Peter A. & Richardson, Jeff & Baron, Jonathan, 2002. "Exploring the role of order effects in person trade-off elicitations," Health Policy, Elsevier, vol. 61(2), pages 189-199, August.
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