| Titre | Théorie de l'utilité et mesure des états de santé, le débat QALYs-HYEs | |
|---|---|---|
| Auteur | Claude Le Pen | |
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Revue | Economie et prévision |
| Numéro | no 129-130, 1997/3-4 Nouvelles approches micro-économiques de la santé | |
| Rubrique / Thématique | Nouvelles approches micro-économiques de la santé Les outils d'analyse et de mesure en économie de la santé |
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| Page | 37-54 | |
| Résumé anglais |
Utility Theory and Health Status measurement: the Debate QALYs vs HYEs
by Claude Le Pen
A vigorous debate has recently opposed int the field on the economic assessment of medical technologies two methods to value health states : the "Quality Adjusted Life Years" (QALYs) and the "Healthy Years Equivalents" (HYEs). For a given health state, the QALYs are defined as the sum of life years allowed in a définie health state, each year being weighted by a coefficient, which reflects the utility of is "quality". The coefficient value varies between 0 and 1, 0 being attached to the worse quality and 1 to the best. This indicator, whose simplicity and intuitive appeal certainly explain the great success, faces nevertheless serious theoretical probems. It can be shown in fact that the preference pattern of an agent who would prefer health state A to health state B if and only if the number of QALYs in A is grater than that in B, obeys a set of restrictive assumptions, so that the psychological profile of the agent lacks credibility. Some authors have thus proposed an alternate measurement, the HYEs, which have the advantage to give an integrated utility measure of both quality and quantity of life, without requiring a complete and restrictive specification of the utility function. More general from a theoretical point of view, this concept proves impossible to be practically implemented. The methods designef to compute empirically the HYEs implicitly require in fact the same limitung assumptions than the QALYs. So, we have from one hand a concept which is easy to implement empirically but without a great theoretical relevance and, from the other hand, a concept which is richer at the theoretical level but is disappointing at the pratical level. Apart from the technical matters, the debate has the interest to reveal the meaning and the limit of the application of utility theory to the measurement of health state. Source : Éditeur (via Persée) |
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| Article en ligne | http://www.persee.fr/web/revues/home/prescript/article/ecop_0249-4744_1997_num_129_3_5863 |
