Investigating the social value of health changes

This survey has demonstrated that the Danish public is concerned with distributional aspects of health gains. They have a strong inclination to give priority to those in a more severe health state provided their expected benefits are large enough to bring them to the health level where their rival patients are without treatment. Results also indicated that the equity argument may not apply with equal force on all health dimensions. Respondents did to some extent trade-off equity for greater health gains. A nouvelle finding is that the valuations of health increments per se seem to be affected by whether questions are framed as individual or social choices. If social decision making is the issue, health gains which involve relieving patients of extreme problems are valued more highly than relief of minor ailments. These discrepancies between individual and social valuations suggest that the use of QALY values elicited from an individual's perspective may not be valid in social decision making. (C) 2004 Elsevier B.V. All rights reserved.