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[The ethical problems in limiting the role for cost-effectiveness].

Lars Sandman1, Thomas Davidson2, Gert Helgesson3

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A limited role for cost-effectiveness in Swedish healthcare priority setting risks unequal care, conflicting with ethical principles. Adjusting thresholds and considering outcomes can mitigate these equality issues.

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Area of Science:

  • Health economics
  • Bioethics
  • Public health policy

Background:

  • Debate on cost-effectiveness in Swedish healthcare priority setting.
  • Current platform emphasizes human dignity and need-solidarity principles.

Purpose of the Study:

  • To perform an ethical analysis of cost-effectiveness in healthcare priority setting.
  • To evaluate the impact of a limited role for cost-effectiveness on ethical principles.
  • To propose mitigation strategies for identified problems.

Main Methods:

  • Ethical analysis of healthcare priority setting frameworks.
  • Examination of Swedish ethical platform principles (human dignity, need-solidarity).
  • Analysis of cost-effectiveness role and its implications.

Main Results:

  • A limited role for cost-effectiveness risks unequal prioritization of similar health needs.
  • This inequality conflicts with core ethical principles of human dignity and need-solidarity.
  • Current practices face challenges with effect comparability and equality.

Conclusions:

  • Explicitly considering outcome measures can improve comparability.
  • Adjusting cost-effectiveness thresholds under specific conditions can address equality concerns.
  • A balanced approach is needed to integrate cost-effectiveness ethically into healthcare priority setting.