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Calibrating QALYs to Respect Equality of Persons

Published online by Cambridge University Press:  23 June 2016

DONALD FRANKLIN
DONALD FRANKLIN*
Affiliation:
UK Department of Health, University College [email protected]
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Abstract

Comparative valuation of different policy interventions often requires interpersonal comparability of benefit. In the field of health economics, the metric commonly used for such comparison, quality adjusted life years (QALYs) gained, has been criticized for failing to respect the equality of all persons’ intrinsic worth, including particularly those with disabilities. A methodology is proposed that interprets ‘full quality of life’ as the best health prospect that is achievable for the particular individual within the relevant budget constraint. This calibration is challenging both conceptually and operationally as it shifts dramatically when technology or budget developments alter what can be achieved for incapacitated individuals. The proposal nevertheless ensures that the maximal achievable satisfaction of one person's preferences can carry no more intrinsic value than that of another. This approach, which can be applied to other domains of social valuation, thus prevents implicit discrimination against the elderly and those with irremediable incapacities.

Type
Research Article
Information
Utilitas , Volume 29 , Issue 1 , March 2017 , pp. 65 - 87
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Copyright
Copyright © Cambridge University Press 2016 

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References

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18 I am grateful to the following for perceptive comments: Eric Nord, Tongtong Qian, the Editor and an anonymous reviewer for Utilitas, members respectively of the Golders Green Kreis, of the Health Economics Study Group of the United Kingdom, and of the London Economics Journal Club of the UK Department of Health. Views expressed are not necessarily those of the Department of Health.