Unprincipled QALYs: A Response to Cubbon

Abstract

Defenders of QALYs persistently and perversely argue from the unexceptionable premise that QALYs (years of quality life-time) are a "basic human need in all times and places" to the unjustified and dangerous conclusions that they are a defensible and perhaps desirable principle to use in determining the allocation of health care resources...There are two separate elements to the QALY and both have their problems, but we should distinguish the nature of the problems. The first is the fact that QALYs value lifetime rather than lives and the second is that they value higher over lower quality of life.