Probability weighting and utility curvature in QALY-based decision making

Quality-Adjusted Life-Years (QALYs) are currently the most important utility model in medical decision making. QALYs are calculated by adjusting years of life for the utility of the health state in which these years are spent. For normative reasons the standard gamble is the preferred method to measure health state utilities, but concern exists about its descriptive properties. Recent theoretical work has suggested that probability weighting can explain anomalies in standard gamble measurement. This paper shows that applying probability weighting in standard gamble measurement increases the consistency of QALYs with individual preferences. The consistency of QALYs with individual preferences is not significantly increased further if utility curvature is also taken into account. (C) 1999 Academic Press.