Recently, for many health economics researchers, empirical estimation of the monetary valuation of a QALY has become an important endeavour. Different philosophical and practical approaches to this have emerged. On one hand, there is the view that, with health care budgets set centrally, decision-making bodies within the system can iterate, from observation of a series of previous decisions, towards the value of a QALY is, i.e. they can search for such a value. Alternatively, and more consistent with the approach taken in other public sectors, individual members of the public are surveyed with the aim of directly eliciting a preference-based – also known as a willingness-to-pay-based (WTP-based) - value of a QALY. While the former is based on supply-side factors and the latter on demand, both in fact suffer from informational deficiencies. Sole reliance on either would necessitate an acceptance or accommodation of chronic inefficiencies in healthcare resource allocation. Based on this observation, this paper makes the case that in order to approach optimal decision making in health care provision, a framework incorporating and thus, to a degree, reconciling these two approaches is to be preferred.
Available at: http://works.bepress.com/rachel_baker/27/