Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-17T15:25:25.280Z Has data issue: false hasContentIssue false

Healthy Years Equivalents Versus Time Trade-off: Ambiguity on Certainty and Uncertainty

Published online by Cambridge University Press:  10 March 2009

Brian E. Rittenhouse
Affiliation:
Université de Montréal

Abstract

Preference assessment literature has debated the equivalence of the healthy years equivalents (HYE) and time trade-off (TTO) methods. The central issue is whether the HYE measures preferences under uncertainty. This work shows that the two stages of the HYE first add and then remove the element of uncertainty so that ultimately the technique does not measure preferences under uncertainty. This makes the HYE, at best, a cumbersome equivalent of the TTO.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Birch, S., & Gafni, A.Cost-effectiveness/utility analyses: Do current decision rules lead us to where we want to be? Journal of Health Economics, 1992, 11, 279–96.CrossRefGoogle ScholarPubMed
2.Buckingham, K.Risks in utility assessment and risks of medical interventions (letter). Medical Decision Making, 1993, 13, 167–68.Google Scholar
3.Canadian Coordinating Office for Health Technology Assessment (CCOHTA). Guidelines for economic evaluation of Pharmaceuticals: Canada, 1 st ed.Ottawa: CCOHTA, 1994.Google Scholar
4.Clemen, R. T.Making hard decisions: An introduction to decision analysis. Belmont, CA: Duxbury Press, 1991.Google Scholar
5.Culyer, A. J., & Wagstaff, A.QALYs versus HYEs. Journal of Health Economics, 1993, 11, 311–23.CrossRefGoogle Scholar
6.Drummond, M., Stoddart, G. L., & Torrance, G. W.Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1987.Google Scholar
7.Drummond, M., Torrance, G. W., & Mason, J.Cost-effectiveness league tables: More harm than good? Social Science and Medicine, 1993, 37, 3340.CrossRefGoogle ScholarPubMed
8.French, S.Decision theory: An introduction to the mathematics of rationality. Chichester, UK: Ellis Horwood Limited, 1988.Google Scholar
9.Fryback, D.QALYs, HYEs, and the loss of innocence. Medical Decision Making, 1993, 13, 271–72.CrossRefGoogle ScholarPubMed
10.Gafni, A.The quality of QALYs (quality-adjusted life years): Do QALYs measure what at least they intend to measure? Health Policy, 1989, 13, 8183.CrossRefGoogle ScholarPubMed
11.Gafni, A., Birch, S., & Mehrez, A.Economics, health and health economics: HYEs versus QALYs. Journal of Health Economics, 1993, 11, 325–39.CrossRefGoogle Scholar
12.Gafni, A., & Mehrez, A.Risks in utility assessment and risks of medical interventions (letter). Medical Decision Making, 1993, 13, 168–69.Google Scholar
13.Gerard, K., & Mooney, G.QALY league tables: Handle with care. Health Economics, 1993, 2, 5964.CrossRefGoogle ScholarPubMed
14.Hornberger, J. C., Redelmeier, D. A., & Peterson, J.Variability among methods to assess patient's well-being and consequent effect on a cost-effectiveness analysis. Journal of Clinical Epidemiology, 1992, 45, 505–12.Google Scholar
15.Johannesson, M., Plishkin, J. S., & Weinstein, M. C.Are healthy-years equivalents an improvement over quality-adjusted life years? Medical Decision Making, 1993, 13, 281–86.CrossRefGoogle ScholarPubMed
16.Kahneman, D., Slovic, P., & Tversky, A.Judgement under uncertainty: Heuristics and biases. Cambridge: Cambridge University Press, 1982.Google Scholar
17.Keeney, R., & Raiffa, H.Decisions with multiple objectives: Preferences and value tradeoffs. Cambridge: Cambridge University Press, 1993.CrossRefGoogle Scholar
18.Loomes, G., & McKenzie, L.The use of QALYs in health care decision making. Social Science and Medicine, 1989, 28, 299308.Google Scholar
19.Mehrez, A., & Gafni, A.Quality-adjusted life years, utility theory and healthy-years equivalents. Medical Decision Making, 1989, 9, 142–49.CrossRefGoogle ScholarPubMed
20.Mehrez, A., & Gafni, A.Evaluating health-related quality of life: An indifference curve interpretation of the time tradeoff technique. Social Science and Medicine, 1990, 31, 1281–83.Google Scholar
21.Mehrez, A., & Gafni, A.Healthy-years equivalents versus quality-adjusted life years. Medical Decision Making, 1993, 13, 287–92.CrossRefGoogle ScholarPubMed
22.Mooney, G.Key issues in health economics. New York: Harvester Wheatsheaf, 1994.Google Scholar
23.O’Brien, B.Measurement of health-related quality of life in the economic evaluation of medicines. Drug Information Journal, 1994, 28, 4553.Google Scholar
24.Read, J. L., Quinn, R. J., Berwick, D. M., et al. Preference for health outcomes: Comparison of assessment methods. Medical Decision Making, 1984, 4, 315–29.Google Scholar
25.Richardson, J.Cost utility analysis: What should be measured? Social Science Medicine, 1994, 39, 721.CrossRefGoogle ScholarPubMed
26.Rittenhouse, B.Potential inconsistencies between cost-effectiveness and cost utility analyses: An upstairs/downstairs socioeconomic distinction. International Journal of Technology Assessment in Health Care, 1995, 11, 365–76.CrossRefGoogle ScholarPubMed
27.Torrance, G. W., Thomas, W. H., & Sackett, D. L.A utility maximization model for evaluation of health care programs. Health Services Research, 1972, 7, 118–33.Google ScholarPubMed
28.von Neumann, J., & Morgenstern, O.Theory of games and economic behavior. Princeton, NJ: Princeton University Press, 1944.Google Scholar