Hostname: page-component-6587cd75c8-r56mn Total loading time: 0 Render date: 2025-04-23T21:59:37.208Z Has data issue: false hasContentIssue false
  • English
  • Français

“The trouble with QALYs…”

Published online by Cambridge University Press:  18 May 2011

Martin Knapp  and
Roshni Mangalore
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

This paper summarises the use of QALYs in evaluating changes in mental health states, highlighting the benefits and challenges of their use in this field. The general principles underlying the QALY measure and the most common methods of measuring QALYs are discussed briefly. Evidence of the usefulness and problems of using this generic measure of health-related quality of life are provided from a sample of recent studies relating to depression, schizophrenia, attention deficit hyperactivity disorder and dementia. In each case, attempts were made to use QALYs to measure changes in health states. While in principle, the QALY is enormously attractive, its suitability for measuring changes in many mental health conditions remains open to doubt as existing tools for generating QALY scores such as the EQ-5D have tended not to perform sufficiently well in reflecting changes in many mental health states. New developmental work is needed to construct better QALY-measuring tools for use in the mental health field. Both the conceptualisation and measurement of QALYs need to be built on a valid, comprehensive model of quality of life specific to a mental health disorder, to ensure that the resultant tool is sensitive enough to pick up changes that would be expected and seen as relevant in the course of the illness.

Type
Editorials
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 4 , December 2007 , pp. 289 - 293
Copyright
Copyright © Cambridge University Press 2007

References

REFERENCES

Chisholm, D., Healy, A. & Knapp, M. (1997). QALYs and mental health care. Social Psychiatry and Psychiatric Epidemiology 32, 68–75.CrossRefGoogle ScholarPubMed
Coucill, W., Bryan, S., Bentham, P., Buckley, A. & Laight, A. (2001). EQ-5D in patients with dementia. Medical Care 39, 760–771.CrossRefGoogle ScholarPubMed
Davies, L., Lewis, S., Jones, P., Barnes, T.R., Gaughran, F., Hayhurst, K., Markwick, A., Lloyd, H. & CUtLASS team (2007). Cost-effectiveness of first-v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy. British Journal of Psychiatry 191, 14–22.CrossRefGoogle ScholarPubMed
de Willige, G., Wiersma, D., Nienhuis, F. & Jenner, J. (2005). Changes in quality of life in chronic psychiatric pateints: a comparison between EuroQol(EQ-5D) and WHOQoL. Quality of Life Research 14, 441–451.CrossRefGoogle Scholar
Dolan, P. & Phil, D. (1997). Modelling valuations for EuroQol health states. Medical Care 35, 1095–1108.CrossRefGoogle ScholarPubMed
Drummond, M., Sculpher, M., Torrance, G., O'Brien, B. & Stoddart, G. (2005). Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press: Oxford.CrossRefGoogle Scholar
Horsman, J., Furlong, W., Feeny, D. & Torrance, G. (2003). The Health Utilities Index (HUI): concepts, measurement properties and applications. Health and Quality of Life Outcomes 1, 54.CrossRefGoogle ScholarPubMed
Kind, P. (1996). The EuroQol instrument: an index of HRQOL. In Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd ed. (ed. Spilker, B.). Lippincott-Raven: Philadelphia, PA.Google Scholar
Lave, J., Frank, R., Schulberg, H. & Kamlet, M.S. (1998). Cost-effectiveness of treatment for major depression in primary care patients. Archives of General Psychiatry 55, 645–651.CrossRefGoogle Scholar
Matza, L., Secnik, K., Mannix, S. & Sallee, F. (2005). Parent-proxy EQ-5D ratings of children with attention deficit hyperactivity disorder in the US and the UK. Pharmacoeconomics 23, 777–790.CrossRefGoogle ScholarPubMed
McCrone, P., Knapp, M., Proudfoot, J., Ryden, C., Cavanagh, K., Shapiro, D.A., Ilson, S., Gray, J.A., Goldberg, D., Mann, A., Marks, I., Everitt, B. & Tylee, A. (2004). Cost-effectiveness of computerised cognitive behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 55–62.CrossRefGoogle ScholarPubMed
Peveler, R., Kendrick, T., Buxton, M.Longworth, L., Baldwin, D., Moore, M., Chatwin, J., Goddard, J., Thornett, A., Smith, H., Campbell, M. & Thompson, C. (2005). A randomised controlled trial to compare the cost-effectiveness of tricyclic antidepressants, selective serotonin reuptake inhibitors and Lofepramine. Health Technology Assessment 9 (16), 1–134.CrossRefGoogle ScholarPubMed