Quality-Adjusted Life Years (QALYs) are the most widely used measure of health in economic evaluations of health care. Within a welfarist framework QALYs are consistent with people's preferences under stringent assumptions. Several authors have argued that QALYs are a valid measure of health within an extra-welfarist framework. This paper studies the applicability of QALYs within the best-known extra-welfarist framework, Sen's capability approach. We propose a procedure to value capability sets and provide a foundation for QALYs within Sen's capability approach. We show that, under appropriate conditions, the ranking of capabilities can be represented locally by a QALY measure and that a willingness to pay for QALYs can be defined. The validity of QALYs as a general measure of health requires the same stringent conditions as in a welfarist framework.

Capability approach, Menu-dependent choice, QALYs
dx.doi.org/10.1016/j.jhealeco.2012.10.004, hdl.handle.net/1765/38379
ERIM Top-Core Articles
Journal of Health Economics
Erasmus Research Institute of Management

Bleichrodt, H, & Quiggin, J. (2013). Capabilities as menus: A non-welfarist basis for QALY evaluation. Journal of Health Economics, 32(1), 128–137. doi:10.1016/j.jhealeco.2012.10.004