The relative value of different QALY types

Emily Lancsar*, Yuanyuan Gu, Dorte Gyrd-Hansen, Jim Butler, Julie Ratcliffe, Liliana Bulfone, Cam Donaldson

*Corresponding author for this work

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The oft-applied assumption in the use of Quality Adjusted Life Years (QALYs) in economic evaluation, that all QALYs are valued equally, has been questioned from the outset. The literature has focused on differential values of a QALY based on equity considerations such as the characteristics of the beneficiaries of the QALYs. However, a key characteristic which may affect the value of a QALY is the type of QALY itself. QALY gains can be generated purely by gains in survival, purely by improvements in quality of life, or by changes in both. Using a discrete choice experiment and a new methodological approach to the derivation of relative weights, we undertake the first direct and systematic exploration of the relative weight accorded different QALY types and do so in the presence of equity considerations; age and severity. Results provide new evidence against the normative starting point that all QALYs are valued equally.
Original languageEnglish
Article number102303
Number of pages13
JournalJournal of Health Economics
Early online date13 Feb 2020
Publication statusPublished - Mar 2020


  • QALYs
  • QALY types
  • relative weights
  • priority setting
  • equity
  • discrete choice experiments


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