Cost-Per-Per-QALY Approach
In the presence of scarcity, allocation of resources is done through prioritisation - deliberate or implicit. The demand for health improvements is much greater than the supply any government can provide (WHO, 2014). Insofar, tradeoffs need to be made when allocating health care resources (Brock, 1999). There are many criteria that can be used to decide where and how health care related resources should be spent, “cost-per-QALY” is one of them that have received considerate academic attention over the last few decades (Alder, 2006). As such, it is key to investigate if this particular criteria has a legitimate weight in this allocation decision process, and if so, within which boundaries.
To do so, in a first section I will briefly define …show more content…
There are multiple benefits of using a cost-per-QALY approach to valuation of health policies.
First, it allows to evaluate the “need” for the intervention, in the sense of the capacity to benefit from the intervention, comparatively to its cost. In a scarce environment, the costs represent lost opportunities for other health improvement (Williams, 1996) - considering that the interventions are somewhat mutually exclusive. Indeed, when it comes to health intervention efficiency does matter as it can vary more than a thousandfold (e.g. tuberculosis prevention measures vs. dialysis). When there is such a wide spectrum of efficiency, other distributive issues are relegated in the …show more content…
Indeed, Olsen, Richardson, Dolan et al. (2003) gather up empirical findings from 64 different studies that shows that the perceived social value of health improvements 1) diminishes in marginal improvement, 2) is dependent on the characteristics of the people that receives it. People also seem to express preferences for allocating health resources to people with higher ill-health, for the younger, or the person with young dependents (children). A cost-per-QALY approach as a purely utilitarian approach does not account for those preferences. Of course, preferences elicited from the majority are not all valid ones, and as such they need to be “laundered” after an ethical screening (Broome, 1991). Additionally, this insensitivity to distribution has also been highlighted by numerous scholars (Dolan, 2011; Alder, 2006; Olsen, 2007, amongst
To do so, in a first section I will briefly define …show more content…
There are multiple benefits of using a cost-per-QALY approach to valuation of health policies.
First, it allows to evaluate the “need” for the intervention, in the sense of the capacity to benefit from the intervention, comparatively to its cost. In a scarce environment, the costs represent lost opportunities for other health improvement (Williams, 1996) - considering that the interventions are somewhat mutually exclusive. Indeed, when it comes to health intervention efficiency does matter as it can vary more than a thousandfold (e.g. tuberculosis prevention measures vs. dialysis). When there is such a wide spectrum of efficiency, other distributive issues are relegated in the …show more content…
Indeed, Olsen, Richardson, Dolan et al. (2003) gather up empirical findings from 64 different studies that shows that the perceived social value of health improvements 1) diminishes in marginal improvement, 2) is dependent on the characteristics of the people that receives it. People also seem to express preferences for allocating health resources to people with higher ill-health, for the younger, or the person with young dependents (children). A cost-per-QALY approach as a purely utilitarian approach does not account for those preferences. Of course, preferences elicited from the majority are not all valid ones, and as such they need to be “laundered” after an ethical screening (Broome, 1991). Additionally, this insensitivity to distribution has also been highlighted by numerous scholars (Dolan, 2011; Alder, 2006; Olsen, 2007, amongst