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Healthy-years Equivalents versus Quality-adjusted Life Years

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  • Abraham Mehrez
  • Amiram Gafni

Abstract

The authors respond to the contention that healthy-years equivalents (HYEs) do not fulfil claims they previously made. They refute the argument for the equivalence of the two-stage lottery and the time tradeoff and show that it fails to recognize the difference between choice problems under uncertainty versus certainty. They also dismiss the claim that HYEs assume risk neutrality with respect to healthy years of life, and show that HYEs are superior to the "general" (risk-averse) form of QALYs because HYEs employ fewer assumptions; in partic ular, they do not assume a specific form of the individual's utility function. The examples they used earlier are demonstrated to be conclusive, and the authors respond to arguments about the practical aspects of using HYEs vs QALYs. Finally, they take issue with the assumption that the roots of the QALY model are all attributable to utility theory. Key words: quality-adjusted life years; healthy-years equivalents; medical decision making; individual preferences; time tradeoff; standard gamble; utility theory. (Med Decis Making 1993;13:287- 292)

Suggested Citation

  • Abraham Mehrez & Amiram Gafni, 1993. "Healthy-years Equivalents versus Quality-adjusted Life Years," Medical Decision Making, , vol. 13(4), pages 287-292, December.
    • Handle: RePEc:sae:medema:v:13:y:1993:i:4:p:287-292
    DOI: 10.1177/0272989X9301300404
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    References listed on IDEAS

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    1. Machina, Mark J, 1987. "Choice under Uncertainty: Problems Solved and Unsolved," Journal of Economic Perspectives, American Economic Association, vol. 1(1), pages 121-154, Summer.
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    Cited by:

    1. Morrison, Gwendolyn C., 1997. "HYE and TTO: What is the difference?," Journal of Health Economics, Elsevier, vol. 16(5), pages 563-578, October.
    2. Ried, Walter, 1998. "QALYs versus HYEs--what's right and what's wrong. A review of the controversy," Journal of Health Economics, Elsevier, vol. 17(5), pages 607-625, October.
    3. Maria Orlando Edelen & M. Audrey Burnam & Katherine E. Watkins & José J. Escarce & Haiden Huskamp & Howard H. Goldman & Gary Rachelefsky, 2008. "Obtaining Utility Estimates of the Health Value of Commonly Prescribed Treatments for Asthma and Depression," Medical Decision Making, , vol. 28(5), pages 732-750, September.
    4. Ried, Walter, 1996. "QALYs versus HYEs - What's Right and What's Wrong," Discussion Papers 544, Institut fuer Volkswirtschaftslehre und Statistik, Abteilung fuer Volkswirtschaftslehre.
    5. Alan M. Garber, 1999. "Advances in Cost-Effectiveness Analysis of Health Interventions," NBER Working Papers 7198, National Bureau of Economic Research, Inc.
    6. Brazier, J & Dolan, P, 2005. "Evidence of preference construction in a comparison of variants of the standard gamble method," MPRA Paper 29760, University Library of Munich, Germany.

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