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The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature

Author

Listed:
  • Aki Tsuchiya

    (Centre for Well-being in Public Policy, School of Health and Related Research, University of Sheffield, a.tsuchiya@sheffield.ac.uk)

  • Paul Dolan

    (Centre for Well-being in Public Policy, University of Sheffield)

Abstract

The numbers of quality-adjusted life years (QALYs) gained are increasingly being used to represent the gains in individual utility from treatment. This requires that the value of a health improvement to an individual is a simple product of gains in quality of life and length of life. The article reports on a systematic review of the literature on 2 issues: whether the value of a state is affected by how long the state lasts, and by states that come before or after it. It was found that individual preferences over health are influenced by the duration of health states and their sequence. However, although there is much variation across individual respondents, the assumptions tend to hold much better when valuations are aggregated across respondents, which is encouraging for economic evaluations that rely on using average (mean or median) values.

Suggested Citation

  • Aki Tsuchiya & Paul Dolan, 2005. "The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature," Medical Decision Making, , vol. 25(4), pages 460-467, July.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:4:p:460-467
    DOI: 10.1177/0272989X05276854
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    References listed on IDEAS

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    1. 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.
    2. Anne Spencer, 2000. "Testing the Additive Independence Assumption in the QALY Model," Working Papers 427, Queen Mary University of London, School of Economics and Finance.
    3. Anne Spencer, 2000. "Testing the Additive Independence Assumption in the QALY Model," Working Papers 427, Queen Mary University of London, School of Economics and Finance.
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    Cited by:

    1. Buckingham, Ken J. & Devlin, Nancy Joy, 2009. "A note on the nature of utility in time and health and implications for cost utility analysis," Social Science & Medicine, Elsevier, vol. 68(2), pages 362-367, January.
    2. Ling Jie Cheng & Annushiah Vasan Thakumar & Le Ann Chen & Rachel Lee-Yin Tan & Meixia Liao & Nan Luo, 2026. "Who Prefers Death to Life in Composite Time Trade-off Interviews, and Why? A Mixed-Methods Study among Asians in Singapore," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 19(2), pages 255-267, March.
    3. 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.
    4. van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
    5. James K. Hammitt, 2017. "Valuing Non-Fatal Health Risks: Monetary and Health-Utility Measures," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 335-356.
    6. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2012. "Using a discrete choice experiment to estimate health state utility values," Journal of Health Economics, Elsevier, vol. 31(1), pages 306-318.
    7. Haode Wang & Donna L. Rowen & Yuen Chen & Clara Mukuria & Deborah Street & Richard Norman, 2026. "Valuing health and wellbeing using discrete choice experiment: exploring feasibility, design effect and international preference similarity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 27(2), pages 339-353, March.
    8. Arthur E. Attema & Matthijs M. Versteegh & Mark Oppe & Werner B. F. Brouwer & Elly A. Stolk, 2013. "Lead Time Tto: Leading To Better Health State Valuations?," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 376-392, April.
    9. Arthur E. Attema & Werner B. F. Brouwer & Jose Luis Pinto‐Prades, 2022. "Reference‐dependent age weighting of quality‐adjusted life years," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2515-2536, December.
    10. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2010. "Using a discrete choice experiment to estimate societal health state utility values," MPRA Paper 29933, University Library of Munich, Germany.
    11. Buckingham, K. & Devlin, N., 2008. "A note on the nature of utility in time and health and implications for cost utility analysis," Working Papers 08/02, Department of Economics, City St George's, University of London.
    12. Sharma, Rajiv & Stano, Miron, 2010. "Implications of an economic model of health states worse than dead," Journal of Health Economics, Elsevier, vol. 29(4), pages 536-540, July.
    13. 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.
    14. Bansback, Nick & Hole, Arne Risa & Mulhern, Brendan & Tsuchiya, Aki, 2014. "Testing a discrete choice experiment including duration to value health states for large descriptive systems: Addressing design and sampling issues," Social Science & Medicine, Elsevier, vol. 114(C), pages 38-48.
    15. Bas Janssen & Mark Oppe & Matthijs Versteegh & Elly Stolk, 2013. "Introducing the composite time trade-off: a test of feasibility and face validity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 5-13, July.
    16. Paul Mark Mitchell & Tracy E. Roberts & Pelham M. Barton & Joanna Coast, 2017. "Applications of the Capability Approach in the Health Field: A Literature Review," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 133(1), pages 345-371, August.
    17. Han Bleichrodt & Umut Keskin & Kirsten I. M. Rohde & Vitalie Spinu & Peter Wakker, 2015. "Discounted Utility and Present Value—A Close Relation," Operations Research, INFORMS, vol. 63(6), pages 1420-1430, December.
    18. Devlin, N. & Tsuchiya, A. & Buckingham, K. & Tilling, C., 2009. "Does the value of quality of life depend on duration?," Working Papers 09/07, Department of Economics, City St George's, University of London.
    19. 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.

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