QALYs (quality-adjusted life-years) versus HYEs (healthy years equivalents)

This paper explores the claim that QALYs are liable to misrepresent consumer preferences and hence lead to decision-makers choosing options which are not those preferred by the public. It also considers the claim that HYEs do not suffer from this defect. We argue that none of the examples offered to date demonstrate the alleged tendency of QALYs to misrepresent preferences. We also show that HYEs are identical to QALY scores obtained from a time tradeoff experiment and therefore that the assumptions about preferences underlying HYEs are just as restrictive as those underlying TTO-based QALYs.