IDEAS home Printed from https://ideas.repec.org/a/hpe/journl/y2022v242i3p111-127.html
   My bibliography  Save this article

QALY Maximization and the Social Optimum

Author

Listed:
  • Guillem López-Casasnovas

    (Universitat Pompeu Fabra)

  • José Luis Pinto Prades

    (Universidad de Navarra)

Abstract

The quality-adjusted life year (QALY) approach as a paradigmatic measure of health outcomes is widely used in the economic evaluation of health policies and is even trying to be emulated in other public policy areas. The objective of this paper is to structure the arguments underlying the use of QALYs in cost-effectiveness analyses, which condition its applicability. To this effect, the paper intervenes in the unreasonable use of the approach in terms of its limitations when prioritizing health services. In short, the authors are generally in favor of the instrument but do not have blanket enthusiasm in support of it.

Suggested Citation

  • Guillem López-Casasnovas & José Luis Pinto Prades, 2022. "QALY Maximization and the Social Optimum," Hacienda Pública Española / Review of Public Economics, IEF, vol. 242(3), pages 111-127, September.
    • Handle: RePEc:hpe:journl:y:2022:v:242:i:3:p:111-127
    as

    Download full text from publisher

    File URL: https://hpe-rpe.org/wp-admin/admin-ajax.php?juwpfisadmin=false&action=wpfd&task=file.download&wpfd_category_id=222&wpfd_file_id=5075&token=3859001152acb52ff0e8a041586d61bb&preview=1
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Xavier Cuadras‐Morató & José‐Luis Pinto‐Prades & José‐María Abellán‐Perpiñán, 2001. "Equity considerations in health care: the relevance of claims," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 187-205, April.
    2. Pinto-Prades, Jose-Luis & Sánchez-Martínez, Fernando-Ignacio & Corbacho, Belen & Baker, Rachel, 2014. "Valuing QALYs at the end of life," Social Science & Medicine, Elsevier, vol. 113(C), pages 5-14.
    3. Bleichrodt, Han & Pinto, Jose Luis & Maria Abellan-Perpinan, Jose, 2003. "A consistency test of the time trade-off," Journal of Health Economics, Elsevier, vol. 22(6), pages 1037-1052, November.
    4. Janel Hanmer & Dasha Cherepanov & Mari Palta & Robert M. Kaplan & David Feeny & Dennis G. Fryback, 2016. "Health Condition Impacts in a Nationally Representative Cross-Sectional Survey Vary Substantially by Preference-Based Health Index," Medical Decision Making, , vol. 36(2), pages 264-274, February.
    5. Ting Zhou & Zhiyuan Chen & Hongchao Li & Feng Xie, 2021. "Using Published Health Utilities in Cost-Utility Analyses: Discrepancies and Issues in Cardiovascular Disease," Medical Decision Making, , vol. 41(6), pages 685-692, August.
    6. Peter P. Wakker, 2008. "Lessons Learned by (from?) an Economist Working in Medical Decision Making," Medical Decision Making, , vol. 28(5), pages 690-698, September.
    7. Mikael Svensson & Fredrik Nilsson & Karl Arnberg, 2015. "Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness," PharmacoEconomics, Springer, vol. 33(11), pages 1229-1236, November.
    8. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    9. Bleichrodt, Han & Herrero, Carmen & Pinto, Jose Luis, 2002. "A proposal to solve the comparability problem in cost-utility analysis," Journal of Health Economics, Elsevier, vol. 21(3), pages 397-403, May.
    10. Han Bleichrodt & Jose Luis Pinto Prades, 2009. "New evidence of preference reversals in health utility measurement," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 713-726, June.
    11. Nancy J. Devlin & Koonal K. Shah & Yan Feng & Brendan Mulhern & Ben van Hout, 2018. "Valuing health‐related quality of life: An EQ‐5D‐5L value set for England," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 7-22, January.
    12. Kaushik Ghosh & Irina Bondarenko & Kassandra L Messer & Susan T Stewart & Trivellore Raghunathan & Allison B Rosen & David M Cutler, 2020. "Attributing medical spending to conditions: A comparison of methods," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-17, August.
    13. S. Fanshel & J. W. Bush, 1970. "A Health-Status Index and its Application to Health-Services Outcomes," Operations Research, INFORMS, vol. 18(6), pages 1021-1066, December.
    14. Bush, J. W. & Fanshel, S. & Chen, M. M., 1972. "Analysis of a tuberculin testing program using a health status index," Socio-Economic Planning Sciences, Elsevier, vol. 6(1), pages 49-68, February.
    15. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    Full references (including those not matched with items on IDEAS)

    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. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2016. "An elicitation of utility for quality of life under prospect theory," Journal of Health Economics, Elsevier, vol. 48(C), pages 121-134.
    2. Attema, Arthur E. & Brouwer, Werner B.F., 2009. "The correction of TTO-scores for utility curvature using a risk-free utility elicitation method," Journal of Health Economics, Elsevier, vol. 28(1), pages 234-243, January.
    3. Spencer, Anne & Rivero-Arias, Oliver & Wong, Ruth & Tsuchiya, Aki & Bleichrodt, Han & Edwards, Rhiannon Tudor & Norman, Richard & Lloyd, Andrew & Clarke, Philip, 2022. "The QALY at 50: One story many voices," Social Science & Medicine, Elsevier, vol. 296(C).
    4. Bengt Liljas & Göran S. Karlsson & Nils‐Olov Stålhammar, 2008. "On future non‐medical costs in economic evaluations," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 579-591, May.
    5. Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
    6. Milton C. Weinstein, 1981. "Economic Assessments of Medical Practices and Technologies," Medical Decision Making, , vol. 1(4), pages 309-330, December.
    7. Arthur E. Attema & Marieke Krol & Job Exel & Werner B. F. Brouwer, 2018. "New findings from the time trade-off for income approach to elicit willingness to pay for a quality adjusted life year," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 277-291, March.
    8. Rosalie Viney & Elizabeth Savage, 2006. "Health care policy evaluation: empirical analysis of the restrictions implied by Quality Adjusted Life Years, CHERE Working Paper 2006/10," Working Papers 2006/10, CHERE, University of Technology, Sydney.
    9. Peter P. Wakker, 2008. "Explaining the characteristics of the power (CRRA) utility family," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1329-1344.
    10. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    11. Hansen, Lise Desireé & Kjær, Trine, 2019. "Disentangling public preferences for health gains at end-of-life: Further evidence of no support of an end-of-life premium," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    12. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier, 2013. "Prospect theory in the health domain: A quantitative assessment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1057-1065.
    13. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    14. Abellán Perpiñán, José Mª & Sánchez Martínez,Fernando I. & Martínez Pérez, Jorge E., 2007. "La medición del bienestar social relacionado con la salud/The Measurement of the Health Related Social Welfare," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 25, pages 927-950, Diciembre.
    15. Luciana Scalone & Peep Stalmeier & Silvano Milani & Paul Krabbe, 2015. "Values for health states with different life durations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(9), pages 917-925, December.
    16. S. Olofsson & U.-G. Gerdtham & L. Hultkrantz & U. Persson, 2018. "Measuring the end-of-life premium in cancer using individual ex ante willingness to pay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 807-820, July.
    17. Moreno-Ternero, Juan D. & Platz, Trine Tornøe & Østerdal, Lars Peter, 2023. "QALYs, DALYs, and HALYs: A unifying framework for the evaluation of population health," Journal of Health Economics, Elsevier, vol. 87(C).
    18. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2015. "Estimating sign-dependent societal preferences for quality of life," Journal of Health Economics, Elsevier, vol. 43(C), pages 229-243.
    19. Arthur Attema & Werner Brouwer, 2012. "The way that you do it? An elaborate test of procedural invariance of TTO, using a choice-based design," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 491-500, August.
    20. Arthur E. Attema & Jona J. Frasch & Olivier L’Haridon, 2022. "Multivariate risk preferences in the quality‐adjusted life year model," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 382-398, February.

    More about this item

    Keywords

    QALY; Cost effectiveness; Thresholds; Economic evaluation; Pharmaeconomics.;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K23 - Law and Economics - - Regulation and Business Law - - - Regulated Industries and Administrative Law
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

    Statistics

    Access and download statistics

    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:hpe:journl:y:2022:v:242:i:3:p:111-127. 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: Miguel Gómez de Antonio (email available below). General contact details of provider: https://edirc.repec.org/data/iefgves.html .

    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.