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Valuing the benefits and costs of health care programmes: where's the 'extra' in extra-welfarism?

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  • Birch, Stephen
  • Donaldson, Cam
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    Abstract

    The application of Sen's notion of capabilities to problems of the allocation of resources to health in the form of an extra-welfarist framework underlies the justification of quality adjusted life years (QALYs) as the method for valuing the benefits of health care. In this paper we critically appraise this application from both conceptual and empirical perspectives. We show that the alleged limitations of the welfarist approach are essentially limitations in its application, not in the capacity of the approach to accommodate the concerns of extra-welfarists. Moreover, the arguments used to justify the application of the extra-welfarist framework are essentially welfarist. We demonstrate that the methods used to measure QALYs share their basic theoretical roots with welfarist valuation methods, such as willingness to pay (WTP). Although QALYs and WTP share many challenges, we argue that WTP provides a method which performs better with respect to those challenges. In the context of evaluating alternative allocations of health care resources we are left asking what is 'extra' in extra-welfarism?

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 56 (2003)
    Issue (Month): 5 (March)
    Pages: 1121-1133

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    Handle: RePEc:eee:socmed:v:56:y:2003:i:5:p:1121-1133

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    Keywords: Economic evaluation Welfarism Extra-welfarism;

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. The potential of the super QALY to reconcile the key contentions in health economics
      by Chris Sampson in The Academic Health Economists' Blog on 2013-05-20 06:54:41
    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
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    Cited by:
    1. Richard D. Smith & Tracey H. Sach, 2009. "Contingent valuation: (still) on the road to nowhere?," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 863-866.
    2. Sanghera, Sabina & Frew, Emma & Kai, Joe & Gupta, Janesh & Elizabeth Roberts, Tracy, 2013. "An assessment of economic measures used in menorrhagia: A systematic review," Social Science & Medicine, Elsevier, Elsevier, vol. 98(C), pages 149-153.
    3. David Whynes & Emma Frew & Jane Wolstenholme, 2005. "Willingness-to-Pay and Demand Curves: A Comparison of Results Obtained Using Different Elicitation Formats," International Journal of Health Care Finance and Economics, Springer, Springer, vol. 5(4), pages 369-386, December.

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