Estimating (quality-adjusted) life-year losses associated with deaths: With application to COVID-19

Health Econ. 2021 Mar;30(3):699-707. doi: 10.1002/hec.4208. Epub 2020 Dec 24.


Many epidemiological models of the COVID-19 pandemic have focused on preventing deaths. Questions have been raised as to the frailty of those succumbing to the COVID-19 infection. In this paper we employ standard life table methods to illustrate how the potential quality-adjusted life-year (QALY) losses associated with COVID-19 fatalities could be estimated, while adjusting for comorbidities in terms of impact on both mortality and quality of life. Contrary to some suggestions in the media, we find that even relatively elderly patients with high levels of comorbidity can still lose substantial life years and QALYs. The simplicity of the method facilitates straightforward international comparisons as the pandemic evolves. In particular, we compare five different countries and show that differences in the average QALY losses for each COVID-19 fatality is driven mainly by differing age distributions for those dying of the disease.

Keywords: COVID-19; QALYs; life tables; quality-adjusted life-years.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • Child
  • Child, Preschool
  • Comorbidity
  • Humans
  • Infant
  • Life Expectancy / trends*
  • Middle Aged
  • Pandemics
  • Quality of Life
  • Quality-Adjusted Life Years*
  • SARS-CoV-2
  • Time Factors
  • United Kingdom / epidemiology
  • Young Adult