The Lack of Theoretical Support for Using Person Trade-offs in QALY-type Models

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Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.
Original languageEnglish
JournalEuropean Journal of Health Economics
Issue number4
Pages (from-to)429–436
Publication statusPublished - 2009
Externally publishedYes


  • Person trade-off
  • QALY
  • DALY
  • Pareto principle
  • Social welfare

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