Are QALYs an appropriate measure for valuing morbidity in acute diseases?

Abstract

In this paper, we examine the problems associated with using quality adjusted life years (QALYs) as the measure of effectiveness to evaluate interventions for acute conditions. We illustrate the way in which using commonly accepted benchmarks for costs per QALY, in order to adopt interventions for acute conditions, might result in decisions that are not consistent with maximizing net societal benefit. We suggest that an alternate methodology, such as willingness to pay, may be more appropriate to make allocation decisions for acute conditions.

Assessment of respondent acceptability for preference measures in stuttering

“…Two of the relevant variables here are the number of health states being compared and the chronicity of the condition being assessed. For chronic conditions, findings support the use of SG over WTP; for temporary conditions, however, research supports the use of WTP over SG (Bala & Zarkin, 2000;. This result can be explained by the fact that considering the maximal amount one is willing to pay for an intervention that affects the rest of one's life is cognitively difficult, especially for a young individual unfamiliar with large purchases.…”

“…The results of this study, therefore, differ somewhat from previous findings that SG may be perceived as preferable to WTP for decision making in chronic conditions (Bala & Zarkin, 2000;. This difference can probably be explained by the magnitude of the interventions: If the goal of the intervention is curing cancer, as it was in one of the studies that reported SG to be preferable to WTP , then WTP decisions may be perceived as more challenging than SG questions because the condition affects not only morbidity but also mortality.…”

Valuing avoided morbidity using meta‐regression analysis: what can health status measures and QALYs tell us about WTP?

“…First, the results cast doubt on the QALY valuation approach for predicting and transferring health benefits, at least for acute conditions. This result is consistent with the findings of others who have been critical of the approach, particularly for valuing changes in acute illness [38]. Second, the strong explanatory power, robustness, and statistical significance of the meta-regressions provide general support for their use as benefit transfer functions for policy analysis.…”

Assessment of Respondent Acceptability of Preference Measures: Discriminatory Power of Graphic Positioning Scale versus Traditional Scaling Measures

“…Furthermore, as part of a larger study requiring respondents to provide WTP bids for CINV and breast cancer states, bids in chronic conditions were notable for ceiling effects [14]. These conclusions are consistent with those reported in 2000 by Bala and Zarkin [12], suggesting that WTP may be a more appropriate utility measure than SG for acute conditions.…”