QALYs and cost-effectiveness thresholds: critical reflections

Rogalewicz, V.; Barták, M.

Central European Conference in Finance and Economics (CEFE2017). Košice: Technická univerzita v Košiciach, Ekonomická fakulta, 2017. pp. 664-677. ISBN 978-80-553-2906-2


We summarize the criticism of utilizing the QALY and cost-effectiveness threshold concept in health-economic studies that is recently growing stronger. Despite of their strong limitations, these tools have been frequently used in many healthcare systems. However, some countries in their political decisions refuse utilization of QALYs and thresholds as optimizing criteria. The critical reflexion concerns both theoretical and experimental foundations. Based on a literary review, fundamental arguments against the concepts are summarized, and a synthesis of material objections is presented. As a whole, the critics´ arguments can be judged as quite strong. Instead of these two concepts, the decision makers should consider the whole spectrum of clinical, economic, moral, political and organizational arguments, and employ also other mathematical models.

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