Use of quality adjusted life years and life years gained as benchmarks in economic evaluations: a critical appraisal.

Researchers have grappled with various ways of placing the results of an economic evaluation in the appropriate context. One of the most common methods is to relate the results of a study to an appropriate benchmark (commonly, dollars 50,000 per QALY in the US or pounds sterling 30,000 per QALY in the UK). This paper examines the foundation for these cut-off points and critiques their use by researchers. Although it is difficult to establish an appropriate benchmark this paper notes that reference points may be too low based on published data. Further, the inconsistent application of benchmarks, and differences in the calculation of a value of a statistical life, will lead to an inefficient allocation of health care resources.