Healthy year equivalents versus quality-adjusted life years: the debate continues
- 1 June 2005
- journal article
- Published by Informa UK Limited in Expert Review of Pharmacoeconomics & Outcomes Research
- Vol. 5 (3), 245-254
- https://doi.org/10.1586/14737167.5.3.245
Abstract
The quality-adjusted life year makes a number of restrictive assumptions about the nature of one's preference over health. The healthy year equivalent was originally proposed over 10 years ago as a major theoretic advance on the quality-adjusted life year. This article reviews the theoretic, empiric and normative bases for the healthy year equivalent and quality-adjusted life year approaches to valuing health profiles that vary over time. Although critics have argued that the two-stage procedure proposed by the developers of healthy year equivalent is theoretically equivalent to a generalized time trade-off question, the notion of directly valuing a series of health states in a health profile has been an important contribution to the literature. Since then, new quality-adjusted life year approaches have been developed to combine health states that vary over time. However, these approaches have yet to be tested empirically. The empiric evidence comparing quality-adjusted life years with healthy year equivalents is equivocal, and the size and direction of difference is context specific. In some studies, no differences have been found. At the same time, where differences are observed, it is difficult to interpret the healthy year equivalent values as the gold standard since there is evidence of cognitive confusion in the answers being given to the valuations of complex health profiles. Based on the evidence to date, it is not clear that healthy year equivalents provide a better measure of preferences than quality-adjusted life years.Keywords
This publication has 52 references indexed in Scilit:
- Differential partitioning of extended experiencesOrganizational Behavior and Human Decision Processes, 2003
- QALYs versus HYEs—what's right and what's wrong. A review of the controversyJournal of Health Economics, 1998
- Sequence Effects, Health Profiles, and the QALY ModelMedical Decision Making, 1998
- Time preference, the discounted utility model and healthJournal of Health Economics, 1996
- Economics, health and health economics: HYEs versus QALYs. A responseJournal of Health Economics, 1995
- Time preference, duration and health state valuationsHealth Economics, 1995
- The Ranking Properties of Healthy-Years Equivalents and Quality-Adjusted Life-Years Under Certainty and UncertaintyInternational Journal of Technology Assessment in Health Care, 1995
- Preferences for sequences of outcomes.Psychological Review, 1993
- Speech and SurvivalNew England Journal of Medicine, 1981
- Fallacy of the Five-Year Survival in Lung CancerNew England Journal of Medicine, 1978