Calculating QALYs and DALYs: Methods and Applications to Fatal and Non-Fatal Conditions
Quality-adjusted life years (QALYs) have been used in the assessment of health interventions for three decades. The popularity of the QALY approach has been constantly increasing, although the debate on its theoretical underpinnings and practical implicat
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Instruments and Methodological Aspects 1.2 Contemporary Issues in Assessment
17 Calculating QALYs and DALYs: Methods and Applications to Fatal and Non-Fatal Conditions F. Sassi 1 1.1 1.2 1.3
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314 The Development of QALYs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 The Development of DALYs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 Additional Sources on QALYs and DALYs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
2 Calculating DALYs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 2.1 Disability Followed by Premature Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318 2.2 Switching Off Age-Weighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 3 Calculating QALYs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320 3.1 QALYs with Quality of Life Varying over Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321 4 Comparing QALYs and DALYs: Practical Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322 4.1 A Non-Fatal Condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322 4.2 A Potentially Fatal Condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323 5
Convergence and Divergence Between QALYs and DALYs . . . . . . . . . . . . . . . . . . . . . . . . 325 Summary Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
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Springer Science+Business Media LLC 2010 (USA)
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Calculating QALYs and DALYs: Methods and Applications to Fatal and Non-Fatal Conditions
Abstract: Quality-adjusted life years (QALYs) have been used in the assessment of health interventions for three decades. The popularity of the QALY approach has been constantly increasing, although the debate on its theoretical underpinnings and practical implications is still ongoing. Disability-adjusted life years (DALYs), also widely debated, were shaped some 20 years later, broadly within the same conceptual framework but with a number of important differences. This chapter provides an illustration of DALY and QALY calculation methods, offering practical instruments for assessing the impact of health interventions. Systematic differences between QALYs and DALYs are explained by reference to two examples: the prevention of tuber
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