QALY-Based Cost-Effectiveness Analysis

en Mathew D. Adler y Marc Fleurbaey (coord.) Oxford Handbook of Well-Being and Public Policy, Oxford University Press, (2016)

Autores: José Mª Abellán, Carmen Herrero Blanco y José Luis Pinto Prades

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This chapter introduces the main ideas about the use of quality-adjusted life years (QALYs) in the evaluation of health policies. It starts by explaining the theoretical underpinnings of the QALY model understood as individual utilities. Afterward, it reviews the empirical evidence about the descriptive validity of the main assumptions supporting the model.

Then, it explains the main preference elicitation techniques (visual analog scale, time trade-off, and standard gamble). It also shows the practical psychological problems faced by these techniques, such as the existence of context-dependent preferences. The chapter ends by explaining how QALYs are used in priority setting, in particular, the rules governing resources allocation decisions using QALYs, the ethical implications of these rules, and the relationship between cost-benefit analysis and cost-effectiveness analysis.

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