Welfarism and extra-welfarism: a critical overview

Seixas, Brayan V.

doi:10.1590/0102-311x00014317

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…However, due to market failures in health care, individuals' preferences must be elicited to value the consequences of implementing health care interventions ( 20 , 21 ). These individual preferences are reflected by what the individuals are willing to pay (or give up) for the outcomes of the healthcare intervention in question; the higher their willingness to pay, the more the individuals prefer the consumption of these healthcare goods/services over alternative goods ( 22 , 23 ). Under this approach, each individual is considered to be the best judge of their own welfare ( 23 , 24 ) and social welfare is typically considered to only be a function of these individual preferences.…”

Section: Differences In the Main Types Of Health Economic Analyses Used For Evaluating Resource Allocation Decisionsmentioning

confidence: 99%

“…There are different interpretations of extra-welfarism, but in practise, they almost exclusively focus on the importance of health as the main outcome of health policies ( 27 ). Consequently, it has been described as introducing an important class of extra welfare sources that allows the consideration of other factors beyond individual utilities/preferences ( 22 , 23 , 28 ). Because under this approach the most important output of health services is considered to be health outcomes ( 28 ), information regarding different health status or health gains can be considered when evaluating interventions ( 24 ).…”

Section: Differences In the Main Types Of Health Economic Analyses Used For Evaluating Resource Allocation Decisionsmentioning

confidence: 99%

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An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations

Turner

Archer

Downey

et al. 2021

Front. Public Health

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Economic evidence is increasingly being used for informing health policies. However, the underlining principles of health economic analyses are not always fully understood by non-health economists, and inappropriate types of analyses, as well as inconsistent methodologies, may be being used for informing health policy decisions. In addition, there is a lack of open access information and methodological guidance targeted to public health professionals, particularly those based in low- and middle-income country (LMIC) settings. The objective of this review is to provide a comprehensive and accessible introduction to economic evaluations for public health professionals with a focus on LMIC settings. We cover the main principles underlining the most common types of full economic evaluations used in healthcare decision making in the context of priority setting (namely cost-effectiveness/cost-utility analyses, cost-benefit analyses), and outline their key features, strengths and weaknesses. It is envisioned that this will help those conducting such analyses, as well as stakeholders that need to interpret their output, gain a greater understanding of these methods and help them select/distinguish between the different approaches. In particular, we highlight the need for greater awareness of the methods used to place a monetary value on the health benefits of interventions, and the potential for such estimates to be misinterpreted. Specifically, the economic benefits reported are typically an approximation, summarising the health benefits experienced by a population monetarily in terms of individual preferences or potential productivity gains, rather than actual realisable or fiscal monetary benefits to payers or society.

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Section: Differences In the Main Types Of Health Economic Analyses Used For Evaluating Resource Allocation Decisionsmentioning

confidence: 99%

Section: Differences In the Main Types Of Health Economic Analyses Used For Evaluating Resource Allocation Decisionsmentioning

confidence: 99%

An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations

Turner

Archer

Downey

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…As mentioned above, there is no single model to evaluate the economic impact of any clinical intervention; rather, there are many different strategies, of which cost-effective analysis (CEA) and cost–benefit analysis (CBA) are the most widely applied. These two systems differentiate on the normative paradigms which support them, extra-welfarism and welfare, respectively [ 118 ]. Extra-welfarism, which supports CEA, focuses on obtaining the maximum overall health status, and welfarism, which supports CBA, looks at individual utilities as its primary outcome.…”

Section: Economic Impact Of Liquid Biopsiesmentioning

confidence: 99%

When Tissue is an Issue the Liquid Biopsy is Nonissue: A Review

et al. 2021

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Precision medicine has impacted the field of medical oncology by introducing personalized therapies, improving all measurable outcomes. This field, in turn, has expanded to obtaining and analyzing a vast and ever-increasing amount of genomic information. One technique currently applied is the liquid biopsy, which consists of detecting and isolating DNA and exosomes in cancer patients. Newly developed techniques have made it possible to use the liquid biopsy in a wide range of settings. However, challenges regarding the validation of its clinical utility exist because of a lack of standardization across different techniques and tumor types, confounder genomic information, lack of appropriate clinical trial designs, and a non-measured, and therefore not estimated, economic impact on population health. Nowadays, liquid biopsy is not routinely used, but ongoing research is increasing its popularity, and a new era in oncology is developing. Therefore, it is essential to have an in-depth understanding of the liquid biopsy technique. In this review, we summarize the leading techniques and liquid biopsy applications in cancer.

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“…Within the realm of health economics, there are two major paradigms dealing with the notion of allocative efficiency: welfarism and extra-welfarism. 4 For the former, the allocation of resources should be carried out in a fashion that maximizes the overall sum of individual utilities as long as the gains of the winners are sufficiently large to compensate the losers for their losses and be still better off (the Potential Pareto Improvement principle). In the welfarist universe, health services are understood in the same way as any other goods and therefore their utility is derived from their consumption.…”

Section: The Notion Of Economic Efficiency In the Context Of Healtmentioning

confidence: 99%

“…People within the lower social ranks have truncated expectations, conditioned by a lifetime (or even generations) of restricted possibilities. “Their horizon of well-being is likely narrowed by the embodiment of the disadvantaged social position.” 4 …”

Section: The Challenging Endeavor Of Engaging the Public In Resourmentioning

confidence: 99%

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy

Seixas

2017

Int J Health Policy Manag

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In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation.

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Welfarism and extra-welfarism: a critical overview

Abstract: Rules and principles for guiding decision-making in the health

Cited by 8 publications

References 20 publications

An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations

An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations

When Tissue is an Issue the Liquid Biopsy is Nonissue: A Review

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy

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