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Quality-adjusted life years
  1. Yolanda Bravo Vergel, Research Fellow,
  2. Mark Sculpher, Professor of Health Economics
  1. Centre for Health Economics, University of York, York, UK
  1. Professor M Sculpher, Centre for Health Economics University of York, Heslington, York YO10 5DD, UK; mjs23{at}


Many health systems now use cost-effectiveness analysis to decide which interventions and programmes to fund. A key issue for such decision making is how to measure health outcomes from interventions to reflect changes in both health-related quality of life and life expectancy. For some decision makers, including the National Institute for Health and Clinical Excellence in the UK, the quality-adjusted life-year (QALY) is central to health measurement. This article describes the concept of the QALY, its derivation, and its strengths and weaknesses.

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