Abstract
quality-of-life impacts, the quality-adjusted life-year (QALY) has beenwidely recognized and endorsed [1–3].The US Panel on Cost-Effectiveness in Health and Medicinerecommended the QALY for “reference case” analyses [2]. TheUK National Institute for Health and Clinical Excellence (NICE)regularly uses QALYs in its technology appraisals [3]. Regulatoryand purchasing agencies in several other European nations,Canada, and Australia likewise recognize the use of QALYs inanalysesofwhethermedicalproductsandinterventionsoffergoodvalue for money [4]. The enthusiasm with which analysts fromacademia and contract research organizations embrace the QALYin economic evaluations is evident from a quick review of theleading health policy evaluation journals or the roster of presen-tations at any recent ISPOR Annual International Meeting [5].As a point of reference for much of the discussion thatfollows, it is useful to define at the outset what we term theconventional QALY:
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