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QALYs, Person Trade-Offs, and the Pareto Principle

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  • Lars Peter Østerdal

    (Institute of Economics, University of Copenhagen)

Abstract

A considerable literature seems to argue the use of person trade-offs to estimate the quality-adjustment factor in Quality-Adjusted Life Years (QALY) models. A similar practise is followed by the WHO to estimate the disability weights used in calculation of Disability-Adjusted Life Years (DALY) for assessment of region- and disease-specific burden of disease. In this note we show that QALY (and DALY) models based on person trade-off scores generally violate the Pareto principle.

Suggested Citation

  • Lars Peter Østerdal, 2004. "QALYs, Person Trade-Offs, and the Pareto Principle," Discussion Papers 04-10, University of Copenhagen. Department of Economics.
  • Handle: RePEc:kud:kuiedp:0410
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    File URL: http://www.econ.ku.dk/english/research/publications/wp/2004/0410.pdf/
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    References listed on IDEAS

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    1. Paul Dolan & Aki Tsuchiya, 2003. "The person trade-off method and the transitivity principle: an example from preferences over age weighting," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 505-510.
    2. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
    3. Jose-Luis Pinto Prades, 1997. "Is the Person Trade-off a Valid Method for Allocating Health Care Resources?," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 71-81.
    4. Peter A. Ubel & Jeff Richardson & Paul Menzel, 2000. "Societal value, the person trade-off, and the dilemma of whose values to measure for cost-effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 127-136.
    5. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
    6. Ubel, Peter A. & Richardson, Jeff & Baron, Jonathan, 2002. "Exploring the role of order effects in person trade-off elicitations," Health Policy, Elsevier, vol. 61(2), pages 189-199, August.
    7. 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.
    8. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
    9. José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2005. "Measuring the health of populations: the veil of ignorance approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 69-82.
    10. Eva Rodríguez-Míguez & José-Luis Pinto-Prades, 2002. "Measuring the social importance of concentration or dispersion of individual health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 43-53.
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    More about this item

    Keywords

    person trade-off; QALY; DALY; Pareto principle; social welfare;

    JEL classification:

    • H4 - Public Economics - - Publicly Provided Goods
    • I1 - Health, Education, and Welfare - - Health
    • D6 - Microeconomics - - Welfare Economics

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