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Are some QALYs more equal than others?

E. Wetering (), Job van Exel (), John Rose (), R. Hoefman and Werner Brouwer ()

The European Journal of Health Economics, 2016, vol. 17, issue 2, 117-127

Abstract: Including societal preferences in allocation decisions is an important challenge for the health care sector. Here, we present results of a phased discrete choice experiment investigating the impact of various attributes on respondents’ preferences for distribution of health and health care. In addition to the renowned equity principles severity of illness (operationalized as initial health) and fair innings (operationalized as age), some characteristics of beneficiaries (culpability and having dependents) and the disease (rarity) were included in the choice experiment. We used a nested logit model to analyse the data. We found that all selected attributes significantly influenced respondents’ choices. The phased inclusion showed that additional attributes affected respondents’ preferences for previously-included attributes and reduced unobserved variance. Although not all these attributes may be considered relevant for decision making from a normative perspective, including them in choice experiments contributes to our understanding of societal preferences for each single attribute. Copyright Springer-Verlag Berlin Heidelberg 2016

Keywords: Healthcare decision making; Equity; Societal preferences; Discrete choice experiment; I180; H510 (search for similar items in EconPapers)
Date: 2016
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DOI: 10.1007/s10198-014-0657-6

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The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

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