Understanding Harris' understanding of CEA: is cost effective resource allocation undone?

Abstract:

:We summarise and evaluate Harris' criticisms of cost-effectiveness analysis (CEA) and the alternative processes he commends to health care decision makers. In contrast to CEA, Harris' asserts that individuals have a right to life-saving treatment that cannot be denied on the basis of their capacity to benefit. We conclude that, whilst Harris' work has challenged the proponents of CEA and quality-adjusted life years to be explicit about the method's indirect discriminatory characteristics, his arguments ignore important questions about what 'lives saved' mean. Harris also attempts to avoid opportunity cost by advocating the same chance of treatment for every person desiring treatment. Using a simple example, we illustrate that an 'equal chances' lottery is not in the interest of any patient, as it reduces the chance of treatment for all patients by leaving some of the health budget unspent.

authors

Edlin R,McCabe C,Round J,Wright J,Claxton K,Sculpher M,Cookson R

doi

10.1258/jhsrp.2012.011057

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

34-9

issue

1

eissn

1355-8196

issn

1758-1060

pii

18/1/34

journal_volume

18

pub_type

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