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Medical Decision Making
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The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature

Aki Tsuchiya, PhD

Centre for Well-being in Public Policy, School of Health and Related Research, University of Sheffield, a.tsuchiya{at}sheffield.ac.uk

Paul Dolan, D. Phil

Centre for Well-being in Public Policy, University of Sheffield

The numbers of quality-adjusted life years (QALYs) gained are increasingly being used to represent the gains in individual utility from treatment. This requires that the value of a health improvement to an individual is a simple product of gains in quality of life and length of life. The article reports on a systematic review of the literature on 2 issues: whether the value of a state is affected by how long the state lasts, and by states that come before or after it. It was found that individual preferences over health are influenced by the duration of health states and their sequence. However, although there is much variation across individual respondents, the assumptions tend to hold much better when valuations are aggregated across respondents, which is encouraging for economic evaluations that rely on using average (mean or median) values.

Key Words: QALYs • individual preferences • utility measurement

Medical Decision Making, Vol. 25, No. 4, 460-467 (2005)
DOI: 10.1177/0272989X05276854
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 Med Decis MakingHome page
M. F. Janssen, E. Birnie, and G. Bonsel
Feasibility and Reliability of the Annual Profile Method for Deriving QALYs for Short-Term Health Conditions
Med Decis Making, July 1, 2008; 28(4): 500 - 510.
[Abstract] [PDF]