QALYs and ageism: philosophical theories and age weighting
AbstractQALY maximization is sometimes criticized for being 'ageist', because, other things being equal, the elderly, with a shorter life expectancy, will be given lower priority. On the other hand, there are philosophical arguments that, for different reasons, advocate rationing health care to the elderly, even when the size of the expected benefits in QALY terms is the same across older and younger patients. This paper examines six proposals, both from the philosophical and the health economics literature, that will lead to such conclusions. These are: two variants of the so-called fair innings argument, the fair innings weights, the Disability Adjusted Life Year (DALY) age weighting, the biographical life span, and the prudential lifetime account. Two questions are addressed with regard to each of these. First, what is the reason for choosing the younger patient when the QALY gains are equal; second, will the younger patient continue to be chosen even when the QALY gains to the older patient are larger. The paper studies the relationship between the six proposals and explores their possible implications for QALY maximization. Copyright © 2000 John Wiley & Sons, Ltd.
Download InfoTo our knowledge, this item is not available for download. To find whether it is available, there are three options:
1. Check below under "Related research" whether another version of this item is available online.
2. Check on the provider's web page whether it is in fact available.
3. Perform a search for a similarly titled item that would be available.
Bibliographic InfoArticle provided by John Wiley & Sons, Ltd. in its journal Health Economics.
Volume (Year): 9 (2000)
Issue (Month): 1 ()
Contact details of provider:
Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Tsuchiya, Aki, 1999. "Age-related preferences and age weighting health benefits," Social Science & Medicine, Elsevier, vol. 48(2), pages 267-276, January.
- Cropper, Maureen L & Aydede, Sema K & Portney, Paul R, 1994. "Preferences for Life Saving Programs: How the Public Discounts Time and Age," Journal of Risk and Uncertainty, Springer, vol. 8(3), pages 243-65, May.
- Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
- Johannesson, Magnus & Johansson, Per-Olov, 1997. "Is the valuation of a QALY gained independent of age? Some empirical evidence," Journal of Health Economics, Elsevier, vol. 16(5), pages 589-599, October.
- Busschbach, Jan J. V. & Hessing, Dick J. & De Charro, Frank Th., 1993. "The utility of health at different stages in life: A quantitative approach," Social Science & Medicine, Elsevier, vol. 37(2), pages 153-158, July.
- Anand, Paul, 2003.
"The integration of claims to health-care: a programming approach,"
Journal of Health Economics,
Elsevier, vol. 22(5), pages 731-745, September.
- Paul Anand, 2002. "The Integration of Claims to Health-Care: a Programming Approach," Open Discussion Papers in Economics 45, The Open University, Faculty of Social Sciences, Department of Economics.
- Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
- Ottersen, Trygve & Mbilinyi, Deogratius & Maestad, Ottar & Norheim, Ole Frithjof, 2008. "Distribution matters: Equity considerations among health planners in Tanzania," Health Policy, Elsevier, vol. 85(2), pages 218-227, February.
- Stolk, Elly A. & Brouwer, Werner B. F. & Busschbach, Jan J. V., 2002. "Rationalising rationing: economic and other considerations in the debate about funding of Viagra," Health Policy, Elsevier, vol. 59(1), pages 53-63, January.
- David L.B. Schwappach, 2003. "Does it matter who you are or what you gain? an experimental study of preferences for resource allocation," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 255-267.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum).
If references are entirely missing, you can add them using this form.