An Alternative to QALYs: The Saved Young Life Equivalent (SAVE)
BMJ (British Medical Journal). 1992 Oct 10; 305(6858): 875-877.
Cost per gained quality adjusted life year (cost per QALY) has been suggested as a criterion for prioritising between different health care programmes. The QALY procedure assigns values to life per se in different health states and focuses on life years rather than persons as the recipients of health improvements. Arguably these two features may be the main causes of public resentment against the use of QALYs in health programme evaluation. Nord outlines an alternative procedure in which society's appreciation of one particular health care outcome -- saving a young life -- is suggested as a unit of value. The unit is called a SAVE. Other health care outcomes may be valued directly in terms of SAVEs by means of a simple equivalence of numbers technique. Like QALYs, SAVEs allow comparisons of different health care programmes in terms of cost: utility ratios. But unlike the QALY procedure the SAVE procedure allows encapsulation of various distributional and ethical rules.
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