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Developing methods that really do value the ‘Q’ in the QALY

Published online by Cambridge University Press:  01 January 2008

Tanaka Business School, Imperial College, London, UK
*Correspondence to: Paul Dolan, Professor of Economics, Tanaka Business School, Imperial College London, South Kensington Campus, London SW7 2AZ, UK. Email:


Most health economists recommend that improvements in health be valued by asking members of the general public to imagine themselves in different states of health and then to think about how many years of life they would give up or what risk of death they would be willing to accept in order to be in full health. In this paper, I argue that preferences are not a very good guide to future experiences and a more suitable way to value health is to ask people in different states of health how they think and feel about their lives. Valuing health in this way may result in greater priority being given to mental health services. Whatever the precise implications, it is my contention that it is much better to ration health care according to real experiences rather than according to hypothetical preferences.

Copyright © Cambridge University Press 2008

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