In many cases it is difficult to apply cost-effectiveness analysis since the health effects are difficult to express in a single effectiveness unit. Apart from affecting survival, a treatment may for instance also affect the health status, which means that the effects on health status will not be included if the gained life years are used as the effectiveness measure. A health care programme may also affect more than one type of event, making it difficult to use the number of avoided events as the effectiveness measure if the types of event are different, e.g. a treatment may reduce the risk of some disease but also increase the risk of some sort of side-effect.


Health Profile Standard Gamble Full Health Quality Adjustment Risk Neutrality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bleichrodt H. QALYs and HYEs: under what conditions are they equivalent? Journal of Health Economics 1995a; 14: 17–37.CrossRefGoogle Scholar
  2. Bleichrodt H. Health utility indices and equity considerations. Mimeo, 1995b.Google Scholar
  3. Boadway RW, Bruce N. Welfare economics. Oxford: Blackwell, 1984.Google Scholar
  4. Boyle MH, Torrance GW, Sinclair JC, Horwood SP. Economic evaluation of neonatal intensive care of very-low-birth-weight infants. New England Journal of Medicine 1983; 308: 1330–7.CrossRefGoogle Scholar
  5. Broome J. Qalys. Journal of Public Economics 1993; 50: 149–167.CrossRefGoogle Scholar
  6. Buchanan JM. Cost and choice: an inquiry in economic theory. Chicago: University of Chicago Press, 1969. Buckingham K. A note on HYE (healthy years equivalent). Journal of Health Economics 1993; 12: 301–309.CrossRefGoogle Scholar
  7. Bush JW, Chen M, Patrick DL Cost-effectiveness using a health status index: analysis of the New York State PKU screening program. hi (Berg R, ed.) Health Status Indexes. Chicago: Hospital Research and Educational Trust, 1973.Google Scholar
  8. Culyer AJ, Wagstaff A. QALYs versus HYEs. Journal of Health Economics 1993; 12: 311–323.CrossRefGoogle Scholar
  9. Gafni A, Birch S, Mehrez A. Economics, health and health economics: HYEs versus QALYs. Journal of Health Economics 1993; 12: 325–339.CrossRefGoogle Scholar
  10. Gafni A, Zylak CJ. Ionic versus nonionic contrast media: a burden or a bargain? Canadian Medical Association Journal 1990; 140: 475–478.Google Scholar
  11. Homberger JC, Redelmeier DA, Peterson J. Variability among methods to assess patients’ well-being and consequent effect on a cost-effectiveness analysis. Journal of Clinical Epidemiology 1992; 45: 505–512.CrossRefGoogle Scholar
  12. Johannesson M, Pliskin JS, Weinstein MC. Are healthy-years equivalents an improvement over quality-adjusted life-years? Medical Decision Making 1993; 13: 281–286.CrossRefGoogle Scholar
  13. Johannesson M, Pliskin JS, Weinstein MC. A note on QALYs, time tradeoff and discounting. Medical Decision Making 1994; 14: 188–193.CrossRefGoogle Scholar
  14. Jönsson B, Horisberger B, Bruguera M, Matter L Cost-benefit analysis of hepatitis-B vaccination. International Journal of Technology Assessment in Health Care 1991; 7: 379–402.CrossRefGoogle Scholar
  15. Kind P, Rosser R, Williams A Valuation of quality of life: some psychometric evidence. In Jones-Lee MW (Ed.). The value of life and safety. Amsterdam: Elsevier/North-Holland, 1982.Google Scholar
  16. Klamman HE, Francis JOS, Rosenthal G. Cost-effectiveness analysis applied to the treatment of chronic renal disease. Medical Care 1968; 6: 48–54.CrossRefGoogle Scholar
  17. Loomes G, McKenzie L The use of QALYs in health care decision making. Social Science and Medicine 1989; 28: 299–308.CrossRefGoogle Scholar
  18. McNeil BJ, Weichselbaum R, Pauker SG. Speech and survival: tradeoffs between quality and quantity of life in laryngeal cancer. New England Journal of Medicine 1981; 305: 982–987.CrossRefGoogle Scholar
  19. Mehrez A Gafni A Quality adjusted life years, utility theory, and healthy-years equivalents. Medical Decision Making 1989; 9: 142–149.CrossRefGoogle Scholar
  20. Mehrez A, Gafti A Healthy-years equivalents versus quality-adjusted life years: in pursuit of progress. Medical Decision Making 1993; 13: 287–292.CrossRefGoogle Scholar
  21. Miyamoto JM, Eraker SA Parametric models of the utility of survival duration: tests of axioms in a genetic utility frameworlc. Organizational Behavior and Human Decision Processes 1989; 44: 162–202.CrossRefGoogle Scholar
  22. Miyamoto JM, Eraker SA Parameter estimates for a QALY utility model. Medical Decision Making 1985; 5: 191–213.CrossRefGoogle Scholar
  23. von Neumann J, Morgenstern O. Theory of Games and Economic Behavior. Princeton: Princeton University Press, 1947.Google Scholar
  24. Pliskin JS, Shepard DS, Weinstein MC. Utility functions for life years and health status. Operations Research 1980; 28: 206–24.CrossRefGoogle Scholar
  25. Pratt JW. Risk aversion in the small and in the large. Econometrica 1964; 32: 122–136.CrossRefGoogle Scholar
  26. Read JL, Quinn RJ, Berwick DM, Fineberg 1W, Weinstein MC. Preference for health outcomes: comparison of assessment methods. Medical Decision Making 1984; 4: 315–329.CrossRefGoogle Scholar
  27. Schoemaker PJH. The expected utility model: its variants, purposes, evidence, and limitations. Journal of Economic Literature 1982; 20: 529–563.Google Scholar
  28. Sonnenberg FA, Beck RJ. Markov models in medical decision making: a practical guide. Medical Decision Making 1993; 13: 322–338.CrossRefGoogle Scholar
  29. Torrance GW. Measurement of health state utilities for economic appraisal: a review. Journal of Health Economics 1986; 5: 1–30.CrossRefGoogle Scholar
  30. Torrance GW, Boyle MH, Horwood SP. Application of multi-attribute utility theory to measure social preferences for health states. Operations Research 1982; 30: 1043–1069.CrossRefGoogle Scholar
  31. Torrance GW, Thomas WH, Sackett DL. A utility maximization model for evaluation of health care programmes. Health Services Research 1972; 7: 118–133.Google Scholar
  32. Weinstein MC, Stason WB. Hypertension: a Policy Perspective. Cambridge, MA Harvard University Press, 1976. Williams A Economics of coronary artery bypass grafting. British Medical Journal 1985; 291: 326–329.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1996

Authors and Affiliations

  • Magnus Johannesson
    • 1
  1. 1.Stockholm School of EconomicsSweden

Personalised recommendations