title: Searchers vs surveyors in estimating the monetary value of a QALY: resolving a nasty dilemma for NICE.
abstract: Recently, for many health economics researchers, empirical estimation of the monetary valuation of a quality-adjusted life year (QALY) has become an important endeavour. Different philosophical and practical approaches to this have emerged. On the one hand, there is a view that, with health-care budgets set centrally, decision-making bodies within the system can iterate, from observation of a series of previous decisions, towards the value of a QALY, thus searching for such a value. Alternatively, and more consistent with the approach taken in other public sectors, individual members of the public are surveyed with the aim of directly eliciting a preference-based - also known as a willingness-to-pay-based (WTP-based) - value of a QALY. While the former is based on supply-side factors and the latter on demand, both in fact suffer from informational deficiencies. Sole reliance on either would necessitate an acceptance or accommodation of chronic inefficiencies in health-care resource allocation. On the basis of this observation, this paper makes the case that in order to approach optimal decision making in health-care provision, a framework incorporating and thus, to a degree, reconciling these two approaches is to be preferred.
authors.affiliation: Yunus Centre for Social Business and Health, Glasgow Caledonian University, Scotland, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Baker
authors.forename: Sue
authors.initials: S
authors.lastname: Chilton
authors.forename: Cam
authors.initials: C
authors.lastname: Donaldson
authors.forename: Michael
authors.initials: M
authors.lastname: Jones-Lee
authors.forename: Emily
authors.initials: E
authors.lastname: Lancsar
authors.forename: Helen
authors.initials: H
authors.lastname: Mason
authors.forename: Hugh
authors.initials: H
authors.lastname: Metcalf
authors.forename: Mark
authors.initials: M
authors.lastname: Pennington
authors.forename: John
authors.initials: J
authors.lastname: Wildman
mesh_terms: D026683:Advisory Committees; D002017:Budgets; D003365:Costs and Cost Analysis / Q000379:methods; D004467:Economics; D005382:Financing, Personal; D006801:Humans; D019057:Quality-Adjusted Life Years; D013222:State Medicine; D006113:United Kingdom