Healthy-years equivalent: wounded but not yet dead

Area of Science:

• Health Economics
• Health Technology Assessment
• Outcome Measurement

Background:

• The quality-adjusted life-year (QALY) is the dominant health outcome measure, despite known flaws in utility elicitation and strong assumptions.
• The healthy-years equivalent (HYE) was proposed as an alternative to address QALY limitations.
• The primary criticism of HYE is its perceived difficulty and impracticality in estimation.

Purpose of the Study:

• To review empirical applications of the healthy-years equivalent (HYE).
• To identify recent methodological advances in estimating HYE.
• To assess the feasibility and potential revival of HYE as a health value measure.

Main Methods:

• Literature review of empirical HYE applications.
• Analysis of recent advances in preference-elicitation methods for HYE.
• Evaluation of HYE's feasibility and comparison to QALY.

Main Results:

• Despite historical debate, the QALY remains dominant.
• Empirical research and methodological advancements demonstrate HYE's feasibility.
• Recent advances address criticisms of HYE's preference-elicitation methods.

Conclusions:

• The healthy-years equivalent (HYE) shows promise as a viable alternative to the QALY.
• Methodological improvements are making HYE estimation more practical.
• Further research and application may re-establish HYE in health technology assessment.