Informing value based pricing in the UK: an elicitation survey of general public preferences for burden of illness, size of therapeutic improvement and end of life

Abstract: The conventional assumption is that a QALY is a QALY regardless of who gets it.  The proposal for value based pricing in the UK proposed that QALYs should be weighted for the burden of the disease and therapeutic improvement. We investigated this claim for the Department of Health through an online survey of 3669 respondents to elicit societal preferences across three characteristics: (1) burden of illness from a medical condition given current health care interventions (i.e. QALY loss per patient from a condition due to both premature mortality measured against normal life expectancy and health related quality of life below one); (2) therapeutic improvement (i.e. whether preferences for large QALY gains are disproportionately larger than the size of the gain); and (3) end of life.