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

  • Rachel Baker (a1) (a2), Sue Chilton (a3) (a4), Cam Donaldson (a5) (a6) (a7), Michael Jones-Lee (a8) (a9), Emily Lancsar (a10) (a11) (a12), Helen Mason (a13), Hugh Metcalf (a14) (a15), Mark Pennington (a16) and John Wildman (a17) (a18)...
Abstract
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.

Copyright
Corresponding author
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
References
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Appleby J., Devlin N., Parkin D., Chalkidou K. Buxton M. (2009), Searching for cost effectiveness thresholds in the NHS, Health Policy, 91: 239245.
Baker R., Chilton S., Jones-Lee M. Metcalf H. (2008), Valuing lives equally: defensible premise or unwarranted compromise?, Journal of Risk and Uncertainty, 36: 125138.
Baker R., Bateman I., Donaldson C., Jones-Lee M., Lancsar E., Loomes G., Mason H., Odejar M., Pinto Prades J.-L., Robinson A., Ryan M., Shackley P., Smith R., Sugden R., Wildman J. (2010), Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY project, Health Technology Assessment, 14(27).
Bate A., Donaldson C. Murtagh M. (2007), Managing to manage scarce resources in the English NHS. What can economics teach? What can economics learn?, Health Policy, 84: 249261.
Broome J. (2004), Weighing Lives, Oxford: Oxford University Press.
Brouwer W., van Exel J., Baker R. Donaldson C. (2008), The new myth: the social value of the QALY, PharmacoEconomics, 26(1): 14.
Culyer A., McCabe C., Briggs A., Claxton K., Buxton M., Akehurst R., Sculpher M. Brazier J. (2007), Searching for a threshold, not setting one: the role of the National Institute for Health and Clinical excellence, Journal of Health Services Research and Policy, 12: 5658.
Devlin N. Parkin D. (2004), Does NICE have a cost-effectiveness threshold and what other factors influence its decisions?, Health Economics, 13: 437452.
Dolan P., Edlin R., Tsuchiya A., Armitage C., Hukin A., Brazier J., Ibbotson R., Bryan S., Eiser D., Olsen J. S. (2008), The relative societal value of health gains to different beneficiaries. Report for the NIHR Methodology Programme, January.
Donaldson C., Birch S. Gafni A. (2002), The pervasiveness of the ‘distribution problem’ in economic evaluation in health care, Health Economics, 11: 5570.
Gold M. R., Siegel J. E., Russell L. B. Weinstein M. C. (1996), Cost-effectiveness in Health and Medicine, New York: Oxford University Press.
Lamiraud K., Von Bremen K. Donaldson C. (2009), The impact of information on patient preferences in different delivery patterns: prescription versus OTC, Health Policy, 93: 102110.
Martin S., Rice N. Smith P. C. (2008), Does health care spending improve health outcomes? Evidence from English programme budgeting data, Journal of Health Economics, 27: 826842.
McCabe C., Claxton K. Culyer A. J. (2008), The NICE cost-effectiveness threshold: what it is and what it means, Pharmacoeconomics, 26: 733744.
Mooney G. (1984). Valuing Human Life in Health Service Policy. Nuffield/York Portfolios No. 3, Nuffield Trust, London.
National Institute for Health and Clinical Excellence (2004), Guide to the Methods of Technology Appraisal, London: National Institute for Health and Clinical Excellence.
Phelps C. E. Mushlin A. I. (1991), On the (near) equivalence of cost-effectiveness and cost–benefit analyses, International Journal of Technology Assessment in Health Care, 7: 1221.
Pinto-Prades J. L., Loomes G. Brey R. (2009), Trying to estimate a monetary value for the QALY, Journal of Health Economics, 28: 553562.
Smith R. Sach T. (2010), Contingent valuation: what needs to be done?, Health Economics, Policy and Law, 5: 91111.
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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
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