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The Quality Adjusted Life Year: A Total-Utility Perspective.

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    The Quality-Adjusted Life Year (QALY) fails as a utilitarian metric for healthcare distribution because it ignores social utility. This paper introduces the Individual-Adjusted Life Year (IALY) as a better utilitarian approach.

    Keywords:
    IALYQALYglee factorhealth economicshealthcare distributionhealthcare ethicssocial and political theorysocial utilityutilitarianismwelfare distribution

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    Area of Science:

    • Health Economics
    • Bioethics
    • Decision Science

    Background:

    • Utilitarianism in healthcare requires evaluating cost-effectiveness against total utility.
    • Current metrics like the Quality-Adjusted Life Year (QALY) do not fully capture social utility increases.
    • This limitation hinders strict utilitarian decision-making in healthcare resource allocation.

    Purpose of the Study:

    • To critically assess the QALY as a utilitarian concept in healthcare distribution.
    • To propose a novel utilitarian metric, the Individual-Adjusted Life Year (IALY).
    • To introduce the 'glee factor' (GF) as a component for the IALY.

    Main Methods:

    • Conceptual analysis of utilitarianism and healthcare metrics.
    • Critique of the QALY's limitations in tracking social utility.
    • Development of the IALY metric and the glee factor (GF).

    Main Results:

    • The QALY is not a strict utilitarian measure due to its inability to track social utility.
    • The proposed IALY metric is designed to be sensitive to both individual and social utility gains.
    • The glee factor (GF) is introduced as a supportive tool for the IALY.

    Conclusions:

    • The QALY falls short of a true utilitarian standard for healthcare distribution.
    • The IALY offers a more robust utilitarian framework by incorporating social utility.
    • The IALY and glee factor provide a refined approach to utilitarian healthcare decision-making.