Do Members of the Public Wish to Give More Weight to Some QALYs than Others? : Results of a Population-based Study in the UK

The National Institute for Health and Clinical Excellence (NICE) in the UK makes recommendations to the NHS on the adoption (or continuation) of therapies. This requires judgements about whether the values/weights attached to gains in quality and length of life should vary according to the characteristics of the patients receiving them, and how much the NHS should be spending (at the margin) to achieve such gains. This paper presents one aspect of a research project that sets out to inform such judgements. One aim of the project is to estimate the relative weights to be attached to a quality adjusted life year (QALY) according to the type of gain (for example, life extending versus quality of life enhancing) as well as the characteristics of the recipients of these gains. We report here the results of a computer assisted 'matching' - or person trade off - valuation study carried out in a sample of 587 members of the public in the UK. The results showed that the public are able to understand complex information concerning QALY gains when those gains are represented diagrammatically and do differentiate between 'types' of QALYs. Our data shows a general tendency to give more weight to younger patients and to those in poorer health, but the pattern is not a simple one. In particular, less weight is given to the youngest patients and to those in poorest health, reversing the pattern found elsewhere in the data. Sub group analyses show significant differences according to age of respondent. The full set of derived weights will be presented and the policy implications discussed