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Searchers vs surveyors in estimating the monetary value of a QALY: resolving a nasty dilemma for NICE

Lookup NU author(s): Dr Rachel Baker, Professor Susan Chilton, Professor Cam Donaldson, Emeritus Professor Michael Jones-Lee, Dr Emily Lancsar, Dr Helen Mason, Dr Hugh Metcalf, Dr Mark Pennington, Professor John WildmanORCiD


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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.

Publication metadata

Author(s): Baker R, Chilton S, Donaldson C, Jones-Lee M, Lancsar E, Mason H, Metcalf H, Pennington M, Wildman J

Publication type: Article

Publication status: Published

Journal: Health Economics, Policy and Law

Year: 2011

Volume: 6

Issue: 4

Pages: 435-447

Print publication date: 22/08/2011

ISSN (print): 1744-1331

ISSN (electronic): 1744-134X

Publisher: Cambridge University Press


DOI: 10.1017/S1744133111000181


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Funder referenceFunder name
G0902066Medical Research Council