Lifetime QALY prioritarianism in priority setting

Abstract

Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications.

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“…Dersom alt anna er likt, så vil langvarig sjukdom med denne definisjonen bli vurdert som meir alvorleg enn kortvarig sjukdom. Det er altså helsetapet over livsløpet som er relevant for alvor (B1 + B2), og ikkje alderen (Td) (19).…”