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QALYs and the equity-efficiency trade-off.

¹School of Social Sciences, University of Sussex, Brighton, UK.

Journal of Health Economics

|April 9, 1991

Summary

Concerns about inequality in healthcare resource allocation are rising with quality-adjusted life years (QALYs) research. This study proposes a new method to address inequality concerns, improving upon current quality-adjusted life years approaches.

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Area of Science:

Health economics
Public health policy
Bioethics

Background:

The increasing use of quality-adjusted life years (QALYs) in healthcare research has raised concerns about equity in resource allocation.
Criticisms often center on the potential for QALYs to exacerbate existing inequalities.

Purpose of the Study:

To identify the core equity concerns within criticisms of the QALY approach.
To propose a novel method for incorporating distributional concerns, specifically inequality, into resource allocation decisions.
To improve upon existing QALY-based methods by addressing limitations in capturing diverse equity considerations.

Main Methods:

Conceptual analysis of criticisms leveled against the QALY framework.
Review of current methods for incorporating distributional concerns into QALY analyses.
Development of a new methodological framework for integrating inequality aversion into resource allocation.

Main Results:

A central theme in QALY critiques is a concern for inequality.
Existing methods for incorporating distributional concerns into QALYs fail to adequately capture inequality.
The proposed method offers a way to integrate both general distributional concerns and specific inequality aversion into decision-making.

Conclusions:

Current QALY-based resource allocation may not adequately address societal concerns about inequality.
A refined approach is needed to ensure equitable distribution of healthcare resources.
The proposed method provides a more comprehensive framework for ethical resource allocation decisions.

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