Economics at your fingertips  

Are Quality-Adjusted Life Years a Good Proxy Measure of Individual Capabilities?

Paul Mark Mitchell (), Sridhar Venkatapuram, Jeff Richardson, Angelo Iezzi and Joanna Coast
Additional contact information
Paul Mark Mitchell: University of Bristol
Sridhar Venkatapuram: King’s College London
Jeff Richardson: Monash University
Angelo Iezzi: Monash University
Joanna Coast: University of Bristol

PharmacoEconomics, 2017, vol. 35, issue 6, 637-646

Abstract: Abstract Background There is a debate in the health economics literature concerning the most appropriate way of applying Amartya Sen’s capability approach in economic evaluation studies. Some suggest that quality-adjusted life years (QALYs) alone are adequate while others argue that this approach is too narrow and that direct measures of capability wellbeing provide a more extensive application of Sen’s paradigm. Objective This paper empirically explores whether QALYs provide a good proxy for individual capabilities. Methods Data is taken from a multinational cross-sectional survey of individuals with seven health conditions (asthma, arthritis, cancer, depression, diabetes, hearing loss, heart disease) and a healthy population. Each individual completed the ICECAP-A measure of capability wellbeing for adults and six health utility instruments that are used to generate QALYs, including EQ-5D and SF-6D. Primary analysis examines how well health utility instruments can explain variation in the ICECAP-A using ordinary least squares regression. Results The findings show that all seven health conditions have a negative association on overall capability as measured by the ICECAP-A index. Inclusion of health utility instruments into separate regressions improves the predictive power of capability but on average, explains less than half of the variation in capability wellbeing. Individuals with arthritis appear to be less inhibited in terms of capability losses when accounting for health utility, yet those who have depression record significant reductions in capability relative to the healthy population even after accounting for the most commonly used health utility instruments. Conclusion The study therefore casts doubt on the ability of QALYs to act as a reliable proxy measure of individuals’ capability.

Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1) Track citations by RSS feed

Downloads: (external link) Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link:

Ordering information: This journal article can be ordered from

Access Statistics for this article

PharmacoEconomics is currently edited by Timothy Wrightson and Christopher I. Carswell

More articles in PharmacoEconomics from Springer
Bibliographic data for series maintained by Sonal Shukla ().

Page updated 2019-11-06
Handle: RePEc:spr:pharme:v:35:y:2017:i:6:d:10.1007_s40273-017-0495-3