Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-17T17:04:02.023Z Has data issue: false hasContentIssue false
  • English
  • Français

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 ,
Sue Chilton ,
Cam Donaldson ,
Michael Jones-Lee ,
Emily Lancsar ,
Helen Mason ,
Hugh Metcalf ,
Mark Pennington  and
John Wildman
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
Get access Rights & Permissions [Opens in a new window]

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
Information
Health Economics, Policy and Law , Volume 6 , Issue 4 , 06 September 2011 , pp. 435 - 447
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Appleby, J., Devlin, N., Parkin, D., Chalkidou, K.Buxton, M. (2009), Searching for cost effectiveness thresholds in the NHS, Health Policy, 91: 239–245.CrossRefGoogle ScholarPubMed
Baker, R., Chilton, S., Jones-Lee, M.Metcalf, H. (2008), Valuing lives equally: defensible premise or unwarranted compromise?, Journal of Risk and Uncertainty, 36: 125–138.CrossRefGoogle Scholar
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).CrossRefGoogle ScholarPubMed
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: 249–261.CrossRefGoogle Scholar
Broome, J. (2004), Weighing Lives, Oxford: Oxford University Press.CrossRefGoogle Scholar
Brouwer, W., van Exel, J., Baker, R.Donaldson, C. (2008), The new myth: the social value of the QALY, PharmacoEconomics, 26(1): 1–4.CrossRefGoogle ScholarPubMed
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: 56–58.CrossRefGoogle Scholar
Devlin, N.Parkin, D. (2004), Does NICE have a cost-effectiveness threshold and what other factors influence its decisions?, Health Economics, 13: 437–452.CrossRefGoogle ScholarPubMed
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.Google Scholar
Donaldson, C., Birch, S.Gafni, A. (2002), The pervasiveness of the ‘distribution problem’ in economic evaluation in health care, Health Economics, 11: 55–70.CrossRefGoogle Scholar
Gold, M. R., Siegel, J. E., Russell, L. B.Weinstein, M. C. (1996), Cost-effectiveness in Health and Medicine, New York: Oxford University Press.CrossRefGoogle ScholarPubMed
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: 102–110.CrossRefGoogle ScholarPubMed
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: 826–842.CrossRefGoogle ScholarPubMed
McCabe, C., Claxton, K.Culyer, A. J. (2008), The NICE cost-effectiveness threshold: what it is and what it means, Pharmacoeconomics, 26: 733–744.CrossRefGoogle Scholar
Mooney, G. (1984). Valuing Human Life in Health Service Policy. Nuffield/York Portfolios No. 3, Nuffield Trust, London.Google Scholar
National Institute for Health and Clinical Excellence (2004), Guide to the Methods of Technology Appraisal, London: National Institute for Health and Clinical Excellence.Google Scholar
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: 12–21.CrossRefGoogle ScholarPubMed
Pinto-Prades, J. L., Loomes, G.Brey, R. (2009), Trying to estimate a monetary value for the QALY, Journal of Health Economics, 28: 553–562.CrossRefGoogle ScholarPubMed
Smith, R.Sach, T. (2010), Contingent valuation: what needs to be done?, Health Economics, Policy and Law, 5: 91–111.CrossRefGoogle Scholar