A major issue in cost effectiveness analysis is that of the value to place on a quality adjusted life year (QALY), commonly used as a measure of health care effectiveness across Europe. This has come to the fore in several European countries, resulting from the creation of national health technology and pharmaceutical assessment agencies. Such agencies were established to make recommendations on technology adoption, addressing issues of affordability and sustainability of publicly-funded health care systems. Recommendations are most often made on the basis of QALYs produced relative to costs incurred. Methods of estimating cost per QALY, based on rigorous decision analytic models, are now very sophisticated. However, 'threshold' values adopted (such as 20-40,000 pounds sterling per QALY above or below which a new therapy will be rejected or recommended for adoption in England) are essentially arbitrary, with little or no economic foundation. This critical policy issue is reflected in the growing interest across Europe in development of more sound methods to elicit such a value.
The EuroVaQ research project will address this issue in two ways:
1. through 'modelling' such a value based on values of statistical lives currently used (or implicit values from adoption decisions in various fields) across Member States; and
2. through survey research to test two methods of deriving a societal willingness-to-pay (WTP) based monetary value of a QALY.