New and robust tests of QALYs when health varies over time

Abstract This paper performs new and more robust tests of the QALY model when health varies over time. Our tests require no confounding assumptions and are robust to violations of expected utility. Our results support the use of QALYs at the aggregate level, i.e. in economic evaluations of health care. At the individual level, the support for QALYs is less convincing. The individual data are, however, largely consistent with a more general QALY-type model that remains tractable in applications. Keywords: QALY, QALYs, utility independence, economic evaluation of health care, decision under risk JEL classification: I10