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Preferences for outcomes in economic evaluation: An economic approach to addressing economic problems

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  • Gafni, Amiram
  • Birch, Stephen

Abstract

In this paper we critically appraise the appropriateness and validity from an economic perspective of alternative preference-based approaches to measuring outcomes in economic evaluations of health care interventions. We describe the properties of an outcome measure for economic evaluation to make it compatible with the principles of economics when applied to the problem of resource allocation. We also describe the difference and similarities between the psychometric and the economic approaches for the measurement of outcome. Using these properties we critically appraise the use of QALY and HYE methods of measuring individual and social preferences for health outcome. We argue that the most advanced measure currently available that meets these required properties is the HYE. Because the HYE, unlike the QALY, has its foundations in utility theory under uncertainty, it neither assumes particular formulations of the individual utility function, nor is it incompatible with the principles of economics. As such it represents a further stage in the continuing development of methods for economic evaluation of health care programmes.

Suggested Citation

  • Gafni, Amiram & Birch, Stephen, 1995. "Preferences for outcomes in economic evaluation: An economic approach to addressing economic problems," Social Science & Medicine, Elsevier, vol. 40(6), pages 767-776, March.
    • Handle: RePEc:eee:socmed:v:40:y:1995:i:6:p:767-776
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    Citations

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    Cited by:

    1. Amiram Gafni, 2006. "Economic Evaluation of Health-care Programmes: Is CEA Better than CBA?," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 34(3), pages 407-418, July.
    2. J. Jaime Caro & John E. Brazier & Jonathan Karnon & Peter Kolominsky-Rabas & Alistair J. McGuire & Erik Nord & Michael Schlander, 2019. "Determining Value in Health Technology Assessment: Stay the Course or Tack Away?," PharmacoEconomics, Springer, vol. 37(3), pages 293-299, March.
    3. Gafni, Amiram & Birch, Stephen, 1997. "QALYs and HYEs Spotting the differences," Journal of Health Economics, Elsevier, vol. 16(5), pages 601-608, October.
    4. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    5. Nicolas Krucien & Amiram Gafni & Nathalie Pelletier‐Fleury, 2015. "Empirical Testing of the External Validity of a Discrete Choice Experiment to Determine Preferred Treatment Option: The Case of Sleep Apnea," Health Economics, John Wiley & Sons, Ltd., vol. 24(8), pages 951-965, August.
    6. John Brazier & Mark Deverill, 1999. "A checklist for judging preference‐based measures of health related quality of life: Learning from psychometrics," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 41-51, February.
    7. 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.
    8. McNamee, Paul, 2007. "What difference does it make? The calculation of QALY gains from health profiles using patient and general population values," Health Policy, Elsevier, vol. 84(2-3), pages 321-331, December.
    9. Mark Sculpher, 1998. "The cost‐effectiveness of preference‐based treatment allocation: the case of hysterectomy versus endometrial resection in the treatment of menorrhagia," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 129-142, March.

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