QALY Maximization and the Social Optimum

  1. GUILLEM LÓPEZ CASASNOVAS 1
  2. JOSÉ LUIS PINTO PRADES 2
  1. 1 Universitat Pompeu Fabra
    info

    Universitat Pompeu Fabra

    Barcelona, España

    ROR https://ror.org/04n0g0b29

  2. 2 Universidad de Navarra
    info

    Universidad de Navarra

    Pamplona, España

    ROR https://ror.org/02rxc7m23

Revista:
Hacienda Pública Española / Review of Public Economics

ISSN: 0210-1173

Año de publicación: 2022

Número: 242

Páginas: 111-127

Tipo: Artículo

DOI: 10.7866/HPE-RPE.22.3.5 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Hacienda Pública Española / Review of Public Economics

Resumen

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.

Referencias bibliográficas

  • Abellán, J. M., Herrero, C. and Pinto-Prades, J. L. (2016), “QALY-Based Cost Effectiveness Analysis”, The Oxford Handbook of Well-Being and Public Policy, chapter 6: 160-192, Oxford UP.
  • Agencia Española de Medicamentos y Productos Sanitarios (2019), “Informe de Posicionamiento Terapéutico e Eluxadolina (Truberzi ®) en el tratamiento del Síndrome del Intestino irritable con diarrea”, IPT, (61/2019). V1. Availabe at: https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPT- eluxadolina-Truberzi.pdf?x74012.
  • Augestad, L. A., Stavem, K., Kristiansen, I. S., Samuelsen, C. H. and Rand-Hendriksen, K. (2016), “Influenced from the start: anchoring bias in time trade-off valuations”, Quality of Life Research, 25(9); 2179-2191.
  • Basu, A., Carlson, J. and Veenstra, D. (2020), “Health Years in Total: A New Health Objective Function for Cost-Effectiveness Analysis”, Value in Health, 23(1): 96-103.
  • Bleichrodt, H., Herrero, C. and Pinto, J. L. (2002), “A proposal to solve the comparability problem in cost-utility analysis”, Journal of Health Economics, 21(3): 397-403.
  • Bleichrodt, H. and Pinto Prades, J. L. (2009), “New evidence of preference reversals in health utility measurement”, Health Economics, 18(6): 713-726.
  • Bleichrodt, H., Pinto-Prades, J. L. and Abellán-Perpiñán, J. M. (2003), “A consistency test of the time trade-off”, Journal of Health Economics, 22(6): 1037-1052.
  • Bush, J. W., Fanshel, S. and Chen, M. M. (1972), “Analysis of a tuberculin testing program using a health status index”, Socio-economic Planning Sciences, 6(1): 49-68.
  • Campillo-Artero, C. (2013), “La regulación de la prestación farmacéutica hoy en España: la opinión de GENESIS contrapunteada por tres voces independientes”, Economía y salud: boletín informativo, (76): 23-30.
  • Claxton, K., Martin, S., Soares, M., Rice, N., Spackman, E., Hinde, S. and Sculpher, M. (2015), “Methods for the estimation of the NICE cost effectiveness threshold”, Health Technology Assessment, 19(14): 1-504.
  • Cockson, R., Griffin, S., Norheim, O. F., Culyer, A. J. and Chalkidou, K. (2021), “Distributional Cost-Effectiveness Analysis Comes of Age”, Value in Health, 24: 118-120.
  • Culter, D. M., Ghosh, K., Bondarenko, I., Messer, K. L., Stewart, S. T., Raghunathan, T. and Rosen, A. B. (2020), “Attributing medical spending to conditions: A comparison of methods”, Plos one, 15(8):e0237082.
  • Cuadras-Morató, X., Pinto-Prades, J. L. and Abellán-Perpiñán, J. M. (2001), “Equity considerations in health care: the relevance of claims”, Health Econ, 10(3): 187-205.
  • Devlin, N., Shah, K., Feng, Y. et al. (2018), “Valuing health-related quality of life: an EQ 5D 5L value set for England”, Health Economics, 27(1): 7-22.
  • Fanshel, S. (1972), “A meaningful measure of health for epidemiology”, International Journal of Epidemiology, 1(4): 319-337.
  • Fanshel, S. and Bush, J. W. (1970), “A health-status index and its application to health-services outcomes”, Operations research, 18(6): 1021-1066.
  • Fanshel and Busch (1970), “When would the assumption of additivity not hold? It would not hold if the law of diminishing returns applied-for example, if being in state SD for 10 days were not 10 times as bad as being in state SD for 1 day, or if a transition from state SF to SC for one person has less value than a transition from state SF to SE for one person, plus a transition from SE to SD for another, plus a transition from SD to SC for a third.” 1041.
  • Hanmer, J., Cherepanov, D., Palta, M., Kaplan, R. M., Feeny, D. and Fryback, D. G. (2016), “Health condition impacts in a nationally representative cross-sectional survey vary substantially by preference-based health index”, Medical Decision Making, 36(2): 264-274.
  • Harris, J. (1995), “Double jeopardy and the veil of ignorance-a reply”, Journal of Medical Ethics, 21(3): 151-157.
  • Harris, J. (1987), “QALYfying the value of life”, Journal of Medical Ethics, 13(3): 117-123.
  • Hernández Álava, M., Wailoo, A. and Pudney, S. (2018), “Quality review of a proposed EQ-5D-5L value set for England”, EEPRU report.