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Are some QALYs more equal than others?

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  • E. Wetering
  • N. Exel
  • J. Rose
  • R. Hoefman
  • W. Brouwer

Abstract

Including societal preferences in allocation decisions is an important challenge for the health care sector. Here, we present results of a phased discrete choice experiment investigating the impact of various attributes on respondents’ preferences for distribution of health and health care. In addition to the renowned equity principles severity of illness (operationalized as initial health) and fair innings (operationalized as age), some characteristics of beneficiaries (culpability and having dependents) and the disease (rarity) were included in the choice experiment. We used a nested logit model to analyse the data. We found that all selected attributes significantly influenced respondents’ choices. The phased inclusion showed that additional attributes affected respondents’ preferences for previously-included attributes and reduced unobserved variance. Although not all these attributes may be considered relevant for decision making from a normative perspective, including them in choice experiments contributes to our understanding of societal preferences for each single attribute. Copyright Springer-Verlag Berlin Heidelberg 2016

Suggested Citation

  • E. Wetering & N. Exel & J. Rose & R. Hoefman & W. Brouwer, 2016. "Are some QALYs more equal than others?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 117-127, March.
    • Handle: RePEc:spr:eujhec:v:17:y:2016:i:2:p:117-127
    DOI: 10.1007/s10198-014-0657-6
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    2. Hausman, Daniel M., 2024. "Problems with NICE's severity weights," Social Science & Medicine, Elsevier, vol. 348(C).
    3. Bae, Eun-Young & Lim, Min Kyoung & Lee, Boram & Bae, Green & Hong, Jihyung, 2023. "Public preferences in healthcare resource allocation: A discrete choice experiment in South Korea," Health Policy, Elsevier, vol. 138(C).
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    5. Wouters, S. & van Exel, N.J.A. & Rohde, K.I.M. & Vromen, J.J. & Brouwer, W.B.F., 2017. "Acceptable health and priority weighting: Discussing a reference-level approach using sufficientarian reasoning," Social Science & Medicine, Elsevier, vol. 181(C), pages 158-167.

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