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Searchers vs surveyors in estimating the monetary value of a QALY: resolving a nasty dilemma for NICE

Published online by Cambridge University Press:  22 August 2011

Rachel Baker
Affiliation:
Yunus Centre for Social Business and Health, Glasgow Caledonian University, Scotland, UK Institute of Health and Society, Newcastle University, England, UK
Sue Chilton
Affiliation:
Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK
Cam Donaldson*
Affiliation:
Yunus Centre for Social Business and Health, Glasgow Caledonian University, Scotland, UK Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK
Michael Jones-Lee
Affiliation:
Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK
Emily Lancsar
Affiliation:
Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK Centre for Health Economics, Monash University, Australia
Helen Mason
Affiliation:
Institute of Health and Society, Newcastle University, England, UK
Hugh Metcalf
Affiliation:
Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK
Mark Pennington
Affiliation:
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, University of London, England, UK
John Wildman
Affiliation:
Institute of Health and Society, Newcastle University, England, UK Newcastle University Business School, Newcastle University, England, UK
*
Correspondence to: Cam Donaldson, Yunus Chair in Social Business and Health, NIHR Senior Investigator and Director, Yunus Centre for Social Business and Health, Institute of Applied Health Research, Glasgow Caledonian University, Level 3 Buchanan House, Cowcaddens Road, Glasgow G4 0BA, UK. Email: cam.donaldson@gcu.ac.uk

Abstract

Recently, for many health economics researchers, empirical estimation of the monetary valuation of a quality-adjusted life year (QALY) has become an important endeavour. Different philosophical and practical approaches to this have emerged. On the one hand, there is a view that, with health-care budgets set centrally, decision-making bodies within the system can iterate, from observation of a series of previous decisions, towards the value of a QALY, thus searching for such a value. Alternatively, and more consistent with the approach taken in other public sectors, individual members of the public are surveyed with the aim of directly eliciting a preference-based – also known as a willingness-to-pay-based (WTP-based) – value of a QALY. While the former is based on supply-side factors and the latter on demand, both in fact suffer from informational deficiencies. Sole reliance on either would necessitate an acceptance or accommodation of chronic inefficiencies in health-care resource allocation. On the basis of this observation, this paper makes the case that in order to approach optimal decision making in health-care provision, a framework incorporating and thus, to a degree, reconciling these two approaches is to be preferred.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

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