A QALY is [still] a QALY is [still] a QALY? : Evaluating proportional shortfall as the answer to the problem of equity in healthcare allocations

Hamideh Mahdiani; Nikolai Münch; Norbert W Paul

doi:10.1186/s12910-024-01036-w

A QALY is [still] a QALY is [still] a QALY? : Evaluating proportional shortfall as the answer to the problem of equity in healthcare allocations

BMC Med Ethics. 2024 Mar 23;25(1):35. doi: 10.1186/s12910-024-01036-w.

Authors

Hamideh Mahdiani¹, Nikolai Münch², Norbert W Paul²

Affiliations

¹ Institute for History, Philosophy and Ethics of Medicine, Johannes Gutenberg University Medical Center, Am Pulverturm 13, 55131, Mainz, Germany. h.mahdiani@uni-mainz.de.
² Institute for History, Philosophy and Ethics of Medicine, Johannes Gutenberg University Medical Center, Am Pulverturm 13, 55131, Mainz, Germany.

Abstract

Despite clinical evidence of drug superiority, therapeutic modalities, like combination immunotherapy, are mostly considered cost-ineffective due to their high costs per life year(s) gained. This paper, taking an ethical stand, reevaluates the standard cost-effectiveness analysis with that of the more recent justice-enhanced methods and concludes by pointing out the shortcomings of the current methodologies.

Keywords: Biomedical Ethics; Cost-effectiveness; Equity; cancer.

Publication types

Letter

MeSH terms

Cost-Benefit Analysis
Delivery of Health Care*
Humans