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Capabilities as menus: A non-welfarist basis for QALY evaluation

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  • Bleichrodt, Han
  • Quiggin, John

Abstract

Quality-Adjusted Life Years (QALYs) are the most widely used measure of health in economic evaluations of health care. Within a welfarist framework QALYs are consistent with people's preferences under stringent assumptions. Several authors have argued that QALYs are a valid measure of health within an extra-welfarist framework. This paper studies the applicability of QALYs within the best-known extra-welfarist framework, Sen's capability approach. We propose a procedure to value capability sets and provide a foundation for QALYs within Sen's capability approach. We show that, under appropriate conditions, the ranking of capabilities can be represented locally by a QALY measure and that a willingness to pay for QALYs can be defined. The validity of QALYs as a general measure of health requires the same stringent conditions as in a welfarist framework.

Suggested Citation

  • Bleichrodt, Han & Quiggin, John, 2013. "Capabilities as menus: A non-welfarist basis for QALY evaluation," Journal of Health Economics, Elsevier, vol. 32(1), pages 128-137.
  • Handle: RePEc:eee:jhecon:v:32:y:2013:i:1:p:128-137
    DOI: 10.1016/j.jhealeco.2012.10.004
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    1. Brouwer, Werner B. F. & van Exel, N. Job A. & Stolk, Elly A., 2005. "Acceptability of less than perfect health states," Social Science & Medicine, Elsevier, vol. 60(2), pages 237-246, January.
    2. Robert Sugden, 2004. "The Opportunity Criterion: Consumer Sovereignty Without the Assumption of Coherent Preferences," American Economic Review, American Economic Association, vol. 94(4), pages 1014-1033, September.
    3. Puppe, Clemens, 1996. "An Axiomatic Approach to "Preference for Freedom of Choice"," Journal of Economic Theory, Elsevier, vol. 68(1), pages 174-199, January.
    4. Han Bleichrodt & Jose Maria Abellan-Perpiñan & Jose Luis Pinto-Prades & Ildefonso Mendez-Martinez, 2007. "Resolving Inconsistencies in Utility Measurement Under Risk: Tests of Generalizations of Expected Utility," Management Science, INFORMS, vol. 53(3), pages 469-482, March.
    5. Machina, Mark J, 1982. ""Expected Utility" Analysis without the Independence Axiom," Econometrica, Econometric Society, vol. 50(2), pages 277-323, March.
    6. Barberà, Salvador & Grodal, Birgit, 2011. "Preference for flexibility and the opportunities of choice," Journal of Mathematical Economics, Elsevier, vol. 47(3), pages 272-278.
    7. M. Fleurbaey., 2012. "Beyond GDP: The Quest for a Measure of Social Welfare," VOPROSY ECONOMIKI, N.P. Redaktsiya zhurnala "Voprosy Economiki", vol. 3.
    8. Faruk Gul & Wolfgang Pesendorfer, 2001. "Temptation and Self-Control," Econometrica, Econometric Society, vol. 69(6), pages 1403-1435, November.
    9. Brouwer, Werner B.F. & Culyer, Anthony J. & van Exel, N. Job A. & Rutten, Frans F.H., 2008. "Welfarism vs. extra-welfarism," Journal of Health Economics, Elsevier, vol. 27(2), pages 325-338, March.
    10. John M. Miyamoto & Peter P. Wakker & Han Bleichrodt & Hans J. M. Peters, 1998. "The Zero-Condition: A Simplifying Assumption in QALY Measurement and Multiattribute Utility," Management Science, INFORMS, vol. 44(6), pages 839-849, June.
    11. Richard Cookson, 2005. "QALYs and the capability approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(8), pages 817-829.
    12. Wulf Gaertner & Yongsheng Xu, 2006. "Capability Sets as the Basis of a New Measure of Human Development," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 7(3), pages 311-321.
    13. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74, pages 132-132.
    14. Martin van Hees, 1998. "On the Analysis of Negative Freedom," Theory and Decision, Springer, vol. 45(2), pages 175-197, October.
    15. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    16. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
    17. Xu, Yongsheng, 2003. "On ranking compact and comprehensive opportunity sets," Mathematical Social Sciences, Elsevier, vol. 45(2), pages 109-119, April.
    18. Kopylov, Igor, 2009. "Finite additive utility representations for preferences over menus," Journal of Economic Theory, Elsevier, vol. 144(1), pages 354-374, January.
    19. Bleichrodt, Han & Diecidue, Enrico & Quiggin, John, 2004. "Equity weights in the allocation of health care: the rank-dependent QALY model," Journal of Health Economics, Elsevier, vol. 23(1), pages 157-171, January.
    20. Jones, Peter & Sugden, Robert, 1982. "Evaluating choice," International Review of Law and Economics, Elsevier, vol. 2(1), pages 47-65, June.
    21. Joanna Coast & Richard Smith & Paula Lorgelly, 2008. "Should the capability approach be applied in Health Economics?," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 667-670.
    22. Pattanaik, Prasanta K. & Xu, Yongsheng, 2000. "On Ranking Opportunity Sets in Economic Environments," Journal of Economic Theory, Elsevier, vol. 93(1), pages 48-71, July.
    23. Marc Fleurbaey, 2005. "Health, Wealth, and Fairness," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 7(2), pages 253-284, May.
    24. Bleichrodt, Han & Quiggin, John, 1999. "Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis?," Journal of Health Economics, Elsevier, vol. 18(6), pages 681-708, December.
    25. Bernt Christian Brun & Bertil Tungodden, 2004. "Non-welfaristic theories of justice: Is “the intersection approach” a solution to the indexing impasse?," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 22(1), pages 49-60, February.
    26. Dekel, Eddie & Lipman, Barton L & Rustichini, Aldo, 2001. "Representing Preferences with a Unique Subjective State Space," Econometrica, Econometric Society, vol. 69(4), pages 891-934, July.
    27. Bleichrodt, Han & Quiggin, John, 1997. "Characterizing QALYs under a General Rank Dependent Utility Model," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 151-165, November.
    28. Sen, Amartya, 1991. "Welfare, preference and freedom," Journal of Econometrics, Elsevier, vol. 50(1-2), pages 15-29, October.
    29. Sen, Amartya K, 1979. "Personal Utilities and Public Judgements: Or What's Wrong with Welfare Economics?," Economic Journal, Royal Economic Society, vol. 89(355), pages 537-558, September.
    30. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-114, November.
    31. Chris Starmer, 2000. "Developments in Non-expected Utility Theory: The Hunt for a Descriptive Theory of Choice under Risk," Journal of Economic Literature, American Economic Association, vol. 38(2), pages 332-382, June.
    32. Oliver, Adam, 2003. "A quantitative and qualitative test of the Allais paradox using health outcomes," Journal of Economic Psychology, Elsevier, vol. 24(1), pages 35-48, February.
    33. Klose, Thomas, 2002. "Life-cycle preferences over consumption and health: a comment on Bleichrodt and Quiggin," Journal of Health Economics, Elsevier, vol. 21(1), pages 161-166, January.
    34. Bleichrodt, Han & Filko, Martin, 2008. "New tests of QALYs when health varies over time," Journal of Health Economics, Elsevier, vol. 27(5), pages 1237-1249, September.
    35. Anand, Paul & Dolan, Paul, 2005. "Equity, capabilities and health," Social Science & Medicine, Elsevier, vol. 60(2), pages 219-222, January.
    36. Bleichrodt, Han & Quiggin, John, 2002. "Life-cycle preferences over consumption and health: a reply to Klose," Journal of Health Economics, Elsevier, vol. 21(1), pages 167-168, January.
    37. Wulf Gaertner & Yongsheng Xu, 2008. "A new class of measures of the standard of living based on functionings," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 35(2), pages 201-215, May.
    38. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
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    Cited by:

    1. Mitchell, Paul Mark & Roberts, Tracy E. & Barton, Pelham M. & Coast, Joanna, 2015. "Assessing sufficient capability: A new approach to economic evaluation," Social Science & Medicine, Elsevier, vol. 139(C), pages 71-79.
    2. repec:spr:chinre:v:11:y:2018:i:1:d:10.1007_s12187-016-9420-0 is not listed on IDEAS
    3. Engel, L. & Chudyk, A.M. & Ashe, M.C. & McKay, H.A. & Whitehurst, D.G.T. & Bryan, S., 2016. "Older adults' quality of life – Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income," Social Science & Medicine, Elsevier, vol. 164(C), pages 1-11.

    More about this item

    Keywords

    Capability approach; QALYs; Menu-dependent choice;

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • D70 - Microeconomics - - Analysis of Collective Decision-Making - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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