Do quality-adjusted life years take account of lost income? Evidence from an Australian survey

The procedures used in cost utility analysis for eliciting quality of life weights have generally omitted any instruction concerning the level of consumption in a health state, despite the fact that some health states preclude the possibility of normal employment. This introduces ambiguity into the interpretation of quality of life (QoL) scores, and project ranking is sensitive to the subsequent treatment of consumption in the analysis. This article reports the results of a study that questioned 131 respondents to a time trade-off (TTO) interview about their assumptions concerning consumption and the amount of thought given to consumption. Results indicate that, without prompting, most assumed unchanged consumption, implying little bias in existing studies.