Although survey work on the value of a QALY has begun to appear in the literature, it has been limited. Typically, individuals have been asked about their WTP for health gains for which quality adjustment factors have been gained from another sample, without fully adjusting for uncertainty (i.e. by presenting scenarios involving certain gains in quality of life) and, in some cases, eliciting values from patients and not from members of the general public (Gyrd-Hansen, 2003; Byrne et al., 2005; King et al., 2005). Only one such estimate exists for a European country (Gyrd-Hansen, 2003). Research proposed in work packages 2-6 would advance the methods in this area and also result in original survey-based monetary values of a QALY.
Cluster 2 - Work packages 2-6
Members of our research team have been involved in almost all of the research to date to elicit WTP-based values for health across Europe and, in some countries (notably the UK and Sweden) across other areas of the public sector. The international body of research relating to WTP is extensive. Thus, the potential problems associated with WTP are well documented. There is good reason to expect considerable difficulties when attempting to attach a monetary value to a QALY. Hence, rather than attempt to deliver a 'definitive' valuation, the purpose of this research will be to thoroughly test two procedures in order to determine whether it is feasible to derive a baseline value of a QALY sufficiently robust to be of use to decision makers. These procedures will be developed and implemented through work packages 2-6 and based on adapting contingent valuation procedures currently used in health economics and the field of transport. Another important consideration is that, through being asked about sacrifices they are individually prepared to make to achieve gains for themselves, these procedures can also be described as consumer-based.
Since all valuation methodologies will be subject to piloting in work already being conducted in some of the participating countries, it would be spurious at this stage to give precise wordings of questions. Rather, we outline below the broad thrust of the research and illustrate with 'example' questions wherever appropriate.