The lack of theoretical support for using person trade-offs in QALY-type models.
Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.
Østerdal
Lars Peter
LP
Department of Economics, University of Copenhagen, Studiestraede 6, 1455 Copenhagen K, Denmark. lars.p.osterdal@econ.ku.dk