The value of health at different ages

Is the value of being healthy the same across all ages? The standard practice of economic evaluation assumes so, and does not discriminate between a QALY (Quality Adjusted Life Year) to an elderly person and one to a child. But on the other hand, it is possible to assume that the value of a healthy year is different according to age, as has been done with DALYs (Disability Adjusted Life Years). This paper is based on a series of interviews designed to elicit and to quantify preferences concerning health at different ages. There were three hypotheses to be tested: (1) that the relative value of health decreases with age, (2) that this decreasing profile is independent of a respondent’s age, and (3) that this age-related preference can be expressed on an interval scale. The results obtained did turn out to depend on a respondent’s age: a mostly negative age-value profile was obtained from younger respondents, but the profile from older respondents had a peak at middle age. Thus, the 1st and 2nd hypotheses were largely rejected. The 3rd hypothesis cannot be rejected, but it should be noted that the variance of the responses was large, thus rendering rejection somewhat less likely. To conclude, the respondents valued a unit of health differently, depending on the age of the patient. While this study does not attempt to determine the exact continuous age-value profile, it found the profile clearly declining beyond middle age.