title: Capabilities as menus: a non-welfarist basis for QALY evaluation.
abstract: Quality-Adjusted Life Years (QALYs) are the most widely used measure of health in economic evaluations of health care. Within a welfarist framework QALYs are consistent with people's preferences under stringent assumptions. Several authors have argued that QALYs are a valid measure of health within an extra-welfarist framework. This paper studies the applicability of QALYs within the best-known extra-welfarist framework, Sen's capability approach. We propose a procedure to value capability sets and provide a foundation for QALYs within Sen's capability approach. We show that, under appropriate conditions, the ranking of capabilities can be represented locally by a QALY measure and that a willingness to pay for QALYs can be defined. The validity of QALYs as a general measure of health requires the same stringent conditions as in a welfarist framework.
authors.affiliation: Erasmus School of Economics & iMTA/iBMG, Erasmus University Rotterdam, The Netherlands. bleichrodt@ese.eur.nl
authors.forename: Han
authors.initials: H
authors.lastname: Bleichrodt
authors.forename: John
authors.initials: J
authors.lastname: Quiggin
mesh_terms: D000203:Activities of Daily Living; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008962:Models, Theoretical; D011787:Quality of Health Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D012946:Social Welfare / Q000191:economics / Q000706:statistics & numerical data