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1994•Medical Decision MakingRequires access

A Note on QALYs, Time Tradeoff, and Discounting

Magnus Johannesson, Joseph S. Pliskin, Milton C. Weinstein

Open publisher page 104 citations

Abstract

The theoretical model of QALYs is based on risk neutrality with respect to life years or constant proportional risk posture with respect to life years. It is shown that discounting of QALYs is inconsistent with these assumptions. For discounting to be consistent with individual preferences in a QALY model, individuals have to be risk-neutral with respect to discounted life years or exhibit constant proportional risk posture with respect to discounted life years. For the time-tradeoff method to be consistent with these assumptions, the QALY weights have to be derived by dividing the number of discounted life years in full health by the number of discounted life years in the assessed health states. Key words: quality-adjusted life years; discounting; time tradeoff; standard gamble; individual preferences. (Med Decis Making 1994;14:188-193)

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What this paper is about

The theoretical model of QALYs is based on risk neutrality with respect to life years or constant proportional risk posture with respect to life years. It is shown that discounting of QALYs is inconsistent with these assumptions. For discounting to be consistent with individual preferences in a QALY model, individuals have to be risk-neutral with respect to discounted life years or exhibit constant proportional risk posture with respect to discounted life years. For the time-tradeoff method to be consistent with these assumptions, the QALY weights have to be derived by dividing the number of discounted life years in full health by the number of discounted life years in the assessed health states. Key words: quality-adjusted life years; discounting; time tradeoff; standard gamble; individual preferences. (Med Decis Making 1994;14:188-193)

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OpenAlex reports 104 citations for this work. Citation counts describe recorded attention and do not establish research quality.

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Available abstract

The theoretical model of QALYs is based on risk neutrality with respect to life years or constant proportional risk posture with respect to life years. It is shown that discounting of QALYs is inconsistent with these assumptions. For discounting to be consistent with individual preferences in a QALY model, individuals have to be risk-neutral with respect to discounted life years or exhibit constant proportional risk posture with respect to discounted life years. For the time-tradeoff method to be consistent with these assumptions, the QALY weights have to be derived by dividing the number of discounted life years in full health by the number of discounted life years in the assessed health states. Key words: quality-adjusted life years; discounting; time tradeoff; standard gamble; individual preferences. (Med Decis Making 1994;14:188-193)

Key concepts: Discounting, Quality-adjusted life year, Time preference, Economics, Actuarial science, Econometrics, Microeconomics, Cost effectiveness

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