Utilities and quality-adjusted life years

Int J Technol Assess Health Care. 1989;5(4):559-75. doi: 10.1017/s0266462300008461.


Utilities and quality-adjusted life years (QALYs) are reviewed, with particular focus on their use in technology assessment. This article provides a broad overview and perspective on these two techniques and their interrelationship, with reference to other sources for details of implementation. The historical development, assumptions, strengths/weaknesses, and applications of each are summarized. Utilities are specifically designed for individual decision-making under uncertainty, but, with additional assumptions, utilities can be aggregated across individuals to provide a group utility function. QALYs are designed to aggregate in a single summary measure the total health improvement for a group of individuals, capturing improvements from impacts on both quantity of life and quality of life--with quality of life broadly defined. Utilities can be used as the quality-adjustment weights for QALYs; they are particularly appropriate for that purpose, and this combination provides a powerful and highly useful variation on cost-effectiveness analysis known as cost-utility analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decision Theory*
  • Economics*
  • Health Policy
  • Humans
  • Life Expectancy*
  • Models, Statistical*
  • Policy Making
  • Quality of Life*
  • Technology Assessment, Biomedical*
  • Value of Life*