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European Value of a Quality Adjusted Life Year

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Welcome to the EuroVaQ website

EuroVaQ was a European Commission research project involving organisations from 10 European countries. The aim of the project was to develop robust methods to determine the monetary value of a quality adjusted life year (QALY) across a number of European Member States.

The project started on 1 April 2007 - for an overview of the project, its objectives and work packages, as per the original proposal, please refer to ''More about EuroVaq'.

The project ended on 31 August 2010 and a comprehensive final report is available to download.

Two main methods were devised and developed for estimating the monetary value of a QALY: the Chained and Direct approach:-

Chained approach

The chained questionnaire consisted of 8 different versions: 4 versions included a Standard Gamble exercise and the other 4, a Time Trade Off exercise (see Table attached).  In both cases, good health was referred to as the pink health state (EQ5D 11111) and this was compared to two other health states; yellow (EQ5D 21121) and green (EQ5D 22222).  Following each SG/TTO exercise, a series of WTP risk/time variant questions were asked.  If the respondent was randomised to the green health state first, the questionnaire would continue with the yellow health state, and vice versa.

Direct approach

The direct questionnaire consists of 4 versions, each containing 4/5 questions. There were 13 questions in total spread across the 4 main versions (see Table attached).  The direct questionnaire started with an introduction to explain the graphs which were used throughout, following which the respondent was asked to enter the age to which they expected to live (life expectancy) and to indicate how healthy they thought they were (health state).   Life expectancy, health state and age were then used throughout the questionnaire to generate questions involving different types of health loss, and accompanying graphs, specific to the respondent.

Q methodology

EuroVaQ also conducted a study to obtain the general public's views on the general principles that should be taken into consideration when prioritising health care. This study involved the use of Q methodology: in this case members of the public were asked to place 34 statements in order of preference. The rankings were subject to by-person factor analysis in order to identify common patterns in the ordering of the statements, which were interpreted and described as views on prioritisation of health care. Respondents carried out the 'Q sort' online. If you would like to participate in the study, instructions are included here.

The questionnaires were all translated into the language of the European collaborators: Dutch, French, Spanish, Norwegian, Danish, Polish, Arabic and Hungarian. For information purposes, they remained available online in a choice of languages until 1 June 2015.  The survey company, with our agreement, has now removed the questionnaires from their internet platform and these are no longer available. Please refer to the EuroVaQ final report for more information.


Mason, H., van Exel, J., Baker, R., Brouwer, W., Donaldson, C. and EuroVaQ Team (2016) 'From Representing Views to Representativeness of Views: illustrating a new (Q2S) approach in the context of health care priority setting in nine European Countries', Social Science & Medicine. 166, pp. 205-213.

van Exel, J., Baker, R., Mason, H., Donaldson, C., Brouwer, W. and EuroVaQ Team (2015) 'Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology', Social Science & Medicine, 126, pp. 128–137

Robinson, A., Gyrd-Hansen, D., Bacon, P., Baker, R., Pennington, M., Donaldson, C. and EuroVaQ Team (2013) 'Estimating a WTP-based value of a QALY: The ‘chained’ approach', Social Science & Medicine, September(92), pp. 92-104.

Pennington, M., Baker, R., Brouwer, W., Mason, H., Gyrd-Hansen, D., Robinson, A., Donaldson, C. and EuroVaQ Team (2013) 'Comparing WTP values of different types of QALY gain elicited from the general public', Health Economics, 24(3), pp. 280-293.

If you are unable to access the above papers, please contact Sue Bell.

Colleagues in the Economics Departments at Konstanz and Martin Luther Universities in Germany have taken some of the ideas of the original EuroVaQ Project and tested them further. This is also useful because Germany was not included in the original EuroVaQ Project. A paper on their work 'What You Ask is What You Get: Willingness-to-Pay for a QALY in Germany' is also available.