The Ranking Properties of Healthy-Years Equivalents and Quality-Adjusted Life-Years Under Certainty and Uncertainty
- 1 January 1995
- journal article
- Published by Cambridge University Press (CUP) in International Journal of Technology Assessment in Health Care
- Vol. 11 (1) , 40-48
- https://doi.org/10.1017/s0266462300005249
Abstract
This paper investigates the theoretical properties of healthy-years equivalents (HYEs) and quality-adjusted life-years (QALYs). A distinction is made between ex ante HYEs (EA-HYEs) and expected HYEs (EXP-HYEs) and between risk-neutral quality-adjusted life-years (RN-QALYs) and risk-adjusted quality adjusted life-years (RA-QALYs). In the case of certainty, HYEs always rank health profiles according to individual preferences, whereas QALYs only rank health profiles according to individual preferences if constant proportional trade-off holds for all health states and if additive independence of quality in different periods holds. In the case of uncertainty, EA-HYEs always rank risky health profiles the same way as expected utility. The assumptions needed for the other measures to rank risky health profiles the same way as expected utility are: risk neutrality with respect to healthy time for EXP-HYEs; risk neutrality with respect to time in all health states and additive independence of quality in different periods for RN-HYEs; and constant proportional risk posture with respect to time in all health states and additive independence of quality in different periods for RA-QALYs.Keywords
This publication has 11 references indexed in Scilit:
- A Note on QALYs, Time Tradeoff, and DiscountingMedical Decision Making, 1994
- Are Healthy-years Equivalents an Improvement over Quality-adjusted Life Years?Medical Decision Making, 1993
- Willingness-to-Pay as a Measure of BenefitsMedical Care, 1991
- The Healthy-years EquivalentsMedical Decision Making, 1991
- Parametric models of the utility of survival duration: Tests of axioms in a generic utility frameworkOrganizational Behavior and Human Decision Processes, 1989
- Quality-adjusted Life Years, Utility Theory, and Healthy-years EquivalentsMedical Decision Making, 1989
- The use of QALYs in health care decision makingSocial Science & Medicine, 1989
- Parameter Estimates for a QALY Utility ModelMedical Decision Making, 1985
- Speech and SurvivalNew England Journal of Medicine, 1981
- Utility Functions for Life Years and Health StatusOperations Research, 1980