Abstract
Cost effectiveness analyses (CEAs) are widely used to evaluate the opportunity cost of health care investments. However, few functions that take equity concerns into account are available for such CEA methods, and these concerns are therefore at risk of being disregarded. Among the functions that have been developed, most focus on the distribution of health gains, as opposed to the distribution of lifetime health. This is despite the fact that there are good reasons to give higher priority to individuals and groups with a low quality adjusted life expectancy from birth (QALE). Also, an even distribution of health gains may imply an uneven distribution of lifetime health. We develop a systematic and explicit approach that allows for the inclusion of lifetime health concerns in CEAs, by creating a new priority weight function, PW = α+(t-γ)·C·e-β·(t-γ), where t is the health measure. PW has several desirable properties. First, it is continuous and smooth, ensuring that people with similar health characteristics are treated alike. For example, those who achieve 50 QALE should be treated similarly to those who achieve 49.9 QALE. Second, it is flexible regarding shape and outcome measure (i.e., caters to other measures than QALE), so that a broad range of values may be modelled. Third, the coefficients have distinct roles. This allows for the easy manipulation of the PW's shape. In order to demonstrate how PW may be applied, we use data from a previous study and estimated the coefficients of PW based on two approaches. Equity concerns are important when conducting CEAs, which means that suitable PWs should be developed. We do not intend to determine which PW is the most appropriate, but to illustrate how a flexible general PW can be estimated based on empirical data.
Highlights
Prioritisation of limited health care resources involves saying no and yes, hard ethical problems and reasonable disagreements
We develop a systematic and explicit approach that allows for the inclusion of lifetime health concerns in cost-effectiveness analysis (CEA), by creating a new priority weight function, priority weight functions (PWs) = α+(t-γ) C e-β (t-γ), where t is the health measure
Equity concerns are important when conducting CEAs, which means that suitable PWs should be developed
Summary
Prioritisation of limited health care resources involves saying no and yes, hard ethical problems and reasonable disagreements. When comparing competing health programs, studies have found that people favor priority to worse off, and they favor interventions that benefit those that are worse off over slightly more cost-effective interventions that benefit better off groups [20, 21] Such equity concerns are too important to leave out from standard CEAs. Cost effectiveness analyses (CEAs) are widely used to evaluate the opportunity cost of health care investments. Among the functions that have been developed, most focus on the distribution of health gains, as opposed to the distribution of lifetime health This is despite the fact that there are good reasons to give higher priority to individuals and groups with a low quality adjusted life expectancy from birth (QALE). An even distribution of health gains may imply an uneven distribution of lifetime health
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
