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Theoretical Foundation of Patient v. Population Preferences in Calculating QALYs

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  • Afschin Gandjour

    (Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, afschin.gandjour@pbrc.edu, The James A. Baker Institute for Public Policy, Rice University, Houston, Texas, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany)

Abstract

The cost-effectiveness of health care interventions is often evaluated using quality-adjusted life years (QALYs) as a measure of outcome. There is a debate on whether QALYs should use patient preferences as opposed to community preferences. This article shows that patient preferences have a theoretical foundation in preference-utilitarian theory and welfare economics. In contrast, this study found no compelling theoretical basis for community preferences. There is a need for further development of a normative framework to inform the choice of preference source.

Suggested Citation

  • Afschin Gandjour, 2010. "Theoretical Foundation of Patient v. Population Preferences in Calculating QALYs," Medical Decision Making, , vol. 30(4), pages 57-63, July.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:4:p:e57-e63
    DOI: 10.1177/0272989X10370488
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    References listed on IDEAS

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    1. Nussbaum, Martha C., 2001. "Symposium on Amartya Sen's philosophy: 5 Adaptive preferences and women's options," Economics and Philosophy, Cambridge University Press, vol. 17(1), pages 67-88, April.
    2. Farina, Francesco & Hahn, Frank & Vannucci, Stefano (ed.), 1996. "Ethics, Rationality, and Economic Behaviour," OUP Catalogue, Oxford University Press, number 9780198289814.
    3. Paul Dolan, 1999. "Whose Preferences Count?," Medical Decision Making, , vol. 19(4), pages 482-486, October.
    4. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
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    Cited by:

    1. Anna Nicolet & Antoinette D I van Asselt & Karin M Vermeulen & Paul F M Krabbe, 2020. "Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-18, July.
    2. Ogorevc, Marko & Murovec, Nika & Fernandez, Natacha Bolanos & Rupel, Valentina Prevolnik, 2019. "Questioning the differences between general public vs. patient based preferences towards EQ-5D-5L defined hypothetical health states," Health Policy, Elsevier, vol. 123(2), pages 166-172.
    3. Paul F M Krabbe & Ruslan Jabrayilov & Patrick Detzel & Livia Dainelli & Karin M Vermeulen & Antoinette D I van Asselt, 2020. "A two-step procedure to generate utilities for the Infant health-related Quality of life Instrument (IQI)," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-14, April.
    4. Anja Schwalm & You-Shan Feng & Jörn Moock & Thomas Kohlmann, 2015. "Differences in EQ-5D-3L health state valuations among patients with musculoskeletal diseases, health care professionals and healthy volunteers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(8), pages 865-877, November.
    5. Afschin Gandjour, 2018. "Patient preferences: a Trojan horse for evidence-based medicine?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 167-172, January.
    6. Utens, Cecile M.A. & Dirksen, Carmen D. & van der Weijden, Trudy & Joore, Manuela A., 2016. "How to integrate research evidence on patient preferences in pharmaceutical coverage decisions and clinical practice guidelines: A qualitative study among Dutch stakeholders," Health Policy, Elsevier, vol. 120(1), pages 120-128.
    7. Paul F M Krabbe, 2013. "A Generalized Measurement Model to Quantify Health: The Multi-Attribute Preference Response Model," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-12, November.
    8. Charles Christian Adarkwah & Amirhossein Sadoghi & Afschin Gandjour, 2016. "Should Cost‐Effectiveness Analysis Include the Cost of Consumption Activities? AN Empirical Investigation," Health Economics, John Wiley & Sons, Ltd., vol. 25(2), pages 249-256, February.

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