A note of the estimation of the equity-efficiency trade-off for QALYs

Article Abstract:

The veil of ignorance approach for assessing the social welfare function of quality-adjusted life-years (QALYs) was studied. The QALY approach has been criticized since it does not consider distribution of health as a factor. Wagstaff has proposed a QALYs which would integrate both efficiency and equity in examining the cost-effectiveness of health maximization. An experiment in which 80 Swedish students were asked to choose between two societies with varying life-expectancies assuming similar health status and incomes was carried out. It was suggested that while QALYs should be used as a basis for studying social choice, more empirical research should be conducted to determining its usefulness.

Research, Quality of life, Life expectancy, Social choice

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Drawing a veil over the measurement of social welfare - a reply to Johannesson

Article Abstract:

Magnus Johannesson's suggested alternative of using a Rawlsian veil of ignorance to derive the right weights that can be applied to QALYs obtained from varying groups is an approach that has been the center of a number of criticisms. It must be pointed out that more than a single method of making the veil operational exists and that disagreement and confusion on the issue is ever present. Placing a veil of ignorance or asking people about the treatment of other individuals are both legitimate ways of discerning health benefit distribution preferences.

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On aggregating QALYs: a comment on Dolan

Article Abstract:

Paul Dolan's empirical formula for estimating the weights of total changes in QALYs in varying groups is shown to have no supporting basis in welfare economics. The primary shortcoming of the technique, which failed in estimating the right amount, is that it only measures the altruistic values that people attach to the health status of other individuals. This approach totally disregard the utility that individuals associate with their personal health status.

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