title: QALY-maximisation and public preferences: results from a general population survey.
abstract: The appropriate criteria that should be used in setting priorities in a publicly funded health care system remain open to debate. From a health economics perspective, quality-adjusted life years (QALYs) are increasingly portrayed as a measure of societal value and the criterion of QALY maximisation is then advocated. This paper reports a study that investigated the extent to which some of the assumptions underlying the QALY maximisation approach, notably constant marginal societal value for increases in the size of health programmes, the level of risk, and the level of benefit are supported by members of the public. A general population interview-based survey was conducted. The survey design employed conjoint methods. In general, the public preference data from this study, in themselves, are not much at odds with the core proportionality assumptions concerning societal value in the QALY maximisation model assumptions. The data are, however, at odds with reports from various previous studies.
authors.affiliation: Health Economics Facility, University of Birmingham, UK. s.bryan@bham.ac.uk
authors.forename: Stirling
authors.initials: S
authors.lastname: Bryan
authors.forename: Tracy
authors.initials: T
authors.lastname: Roberts
authors.forename: Chris
authors.initials: C
authors.lastname: Heginbotham
authors.forename: Alison
authors.initials: A
authors.lastname: McCallum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D005260:Female; D015276:Health Care Rationing / Q000941:ethics / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011639:Public Opinion; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation; D018570:Risk Assessment; D012945:Social Values; D016019:Survival Analysis; D006113:United Kingdom