Reply to Martin Lally’s post on NZAE Asymmetric Information 5/10/22 ‘The Economics of Saving Lives’
The promotion of the utilisation of QALYs as a general measure of disease burden to support business decisions for health expenditure or risk management is of concern.
During an incursion of a previously unknown disease (for example COVID-19) when high mortality is evident and the long-term outcome for survivors is unknown a monetary approach using Statistical Value of Life is more appropriate and can be weighted relative to each country’s wealth for immediate comparison globally of the impact on society, including business. Similarly for natural disasters and sudden unpredicted events that may arise due to Climate Change.
Consideration of a person’s satisfaction with life is a personal assessment and should stay in the realm of an individual’s decision. QALY assessments can’t be generalised over a population with any certainty.
People regardless of age or existing health limitations will work to improve their circumstances changing their QALY over time. A QALY estimate today may be irrelevant tomorrow.
There is research for therapeutics that will generate cures or greater amelioration for genetic disorders, cancers, and chronic illnesses for both young and old. Possibilities of interventions in disorders that arise later in life such as Parkinson’s disease are not accounted for and could be underfunded if the application of such research was just considered in terms of QALYs.
Funding decisions made using QALYs do not factor in the personal contribution to society (including taxation) individuals have made during their life or their expectation that treatment would be available to them through the health system.
QALYs may be appropriate to use to inform a Cost Effectiveness Analysis but the moral hazard must be borne in mind, including determinations related to certain sectors of society such as the disabled, indigenous populations, women and the aged.
Reply to Martin Lally’s post on NZAE Asymmetric Information 5/10/22 ‘The Economics of Saving Lives’
The promotion of the utilisation of QALYs as a general measure of disease burden to support business decisions for health expenditure or risk management is of concern.
During an incursion of a previously unknown disease (for example COVID-19) when high mortality is evident and the long-term outcome for survivors is unknown a monetary approach using Statistical Value of Life is more appropriate and can be weighted relative to each country’s wealth for immediate comparison globally of the impact on society, including business. Similarly for natural disasters and sudden unpredicted events that may arise due to Climate Change.
Consideration of a person’s satisfaction with life is a personal assessment and should stay in the realm of an individual’s decision. QALY assessments can’t be generalised over a population with any certainty.
People regardless of age or existing health limitations will work to improve their circumstances changing their QALY over time. A QALY estimate today may be irrelevant tomorrow.
There is research for therapeutics that will generate cures or greater amelioration for genetic disorders, cancers, and chronic illnesses for both young and old. Possibilities of interventions in disorders that arise later in life such as Parkinson’s disease are not accounted for and could be underfunded if the application of such research was just considered in terms of QALYs.
Funding decisions made using QALYs do not factor in the personal contribution to society (including taxation) individuals have made during their life or their expectation that treatment would be available to them through the health system.
QALYs may be appropriate to use to inform a Cost Effectiveness Analysis but the moral hazard must be borne in mind, including determinations related to certain sectors of society such as the disabled, indigenous populations, women and the aged.
Gail Duncan, Independent Economic Researcher