Valuing qalys at the end of life
There have been changes in the way that NICE evaluates medical treatments for patients who are in the last stages of their lives. If medicines fulfil some criteria to be considered “end of life” NICE considers if QALYs gained under these circumstances should receive an extra weight. In this paper we provide evidence about the social support that this policy may have. We present the result of three surveys conducted in the Spanish general population (n=813). Survey 1 compared increases in life expectancy for patients at the end of their lives with health gains from temporary health problems. Survey 2 compared health gains for temporary health problems with health gains from end of life palliative care. Survey 3 compared increases in life expectancy with palliative care in both cases for end of life patients. Preferences were elicited with Person Trade-Off and Willingness to pay techniques. Our results suggest that QALYs for end of life treatments have a higher social value than for temporary health problems. However, we also find that people discriminate between different ways of health gains within End of Life treatment. People seem to attach a greater weight to palliative care than to life extension.
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