IDEAS home Printed from https://ideas.repec.org/a/sae/pophec/v22y2023i1p76-99.html
   My bibliography  Save this article

Should health research funding be proportional to the burden of disease?

Author

Listed:
  • Joseph Millum

Abstract

Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/AIDS research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific opportunities are equal, each patient merits research into their condition proportional to the burden of disease for which that condition is responsible. This claim—the proportional view —is widely accepted but has never been fully specified or defended. In this paper, I explain what is required to specify the view, attempt to do so in the most charitable way, and then critically evaluate its normative underpinnings. I conclude that a severity-weighted proportional view is defensible. I close by drawing out five key lessons of my analysis for health research priority-setting.

Suggested Citation

  • Joseph Millum, 2023. "Should health research funding be proportional to the burden of disease?," Politics, Philosophy & Economics, , vol. 22(1), pages 76-99, February.
    • Handle: RePEc:sae:pophec:v:22:y:2023:i:1:p:76-99
    DOI: 10.1177/1470594X221138729
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/1470594X221138729
    Download Restriction: no
    File URL: https://libkey.io/10.1177/1470594X221138729?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    2. Fleurbaey, Marc, 2015. "Equality Versus Priority: How Relevant Is The Distinction?," Economics and Philosophy, Cambridge University Press, vol. 31(2), pages 203-217, July.
    3. Leslie A Gillum & Christopher Gouveia & E Ray Dorsey & Mark Pletcher & Colin D Mathers & Charles E McCulloch & S Claiborne Johnston, 2011. "NIH Disease Funding Levels and Burden of Disease," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-9, February.
    4. Parfit, Derek, 2012. "Another Defence of the Priority View," Utilitas, Cambridge University Press, vol. 24(3), pages 399-440, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Matthijs M. Versteegh & Isaac Corro Ramos & Nasuh C. Buyukkaramikli & Amir Ansaripour & Vivian T. Reckers-Droog & Werner B. F. Brouwer, 2019. "Severity-Adjusted Probability of Being Cost Effective," PharmacoEconomics, Springer, vol. 37(9), pages 1155-1163, September.
    2. Erik Nord, 2015. "Cost-Value Analysis of Health Interventions: Introduction and Update on Methods and Preference Data," PharmacoEconomics, Springer, vol. 33(2), pages 89-95, February.
    3. Ciarli, Tommaso & Ràfols, Ismael, 2019. "The relation between research priorities and societal demands: The case of rice," Research Policy, Elsevier, vol. 48(4), pages 949-967.
    4. Shlomi Segall, 2015. "In defense of priority (and equality)," Politics, Philosophy & Economics, , vol. 14(4), pages 343-364, November.
    5. McHugh, Neil & Pinto-Prades, José Luis & Baker, Rachel & Mason, Helen & Donaldson, Cam, 2020. "Exploring the relative value of end of life QALYs: Are the comparators important?," Social Science & Medicine, Elsevier, vol. 245(C).
    6. Anna Nicolet & Antoinette D I van Asselt & Karin M Vermeulen & Paul F M Krabbe, 2020. "Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-18, July.
    7. Eduardo Martínez-Martínez & María Luisa Zaragoza & Elmer Solano & Brenda Figueroa & Patricia Zúñiga & Juan P Laclette, 2012. "Health Research Funding in Mexico: The Need for a Long-Term Agenda," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-11, December.
    8. Donna Rowen & John Brazier & Anju Keetharuth & Aki Tsuchiya & Clara Mukuria, 2016. "Comparison of Modes of Administration and Alternative Formats for Eliciting Societal Preferences for Burden of Illness," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 89-104, February.
    9. Liesbet Wetering & Job Exel & Ana Bobinac & Werner Brouwer, 2015. "Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 33(12), pages 1289-1300, December.
    10. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    11. Hannah Christensen & Hareth Al-Janabi & Pierre Levy & Maarten J. Postma & David E. Bloom & Paolo Landa & Oliver Damm & David M. Salisbury & Javier Diez-Domingo & Adrian K. Towse & Paula K. Lorgelly & , 2020. "Economic evaluation of meningococcal vaccines: considerations for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 297-309, March.
    12. Geir B. Asheim, 2017. "Sustainable growth," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 49(3), pages 825-848, December.
    13. Kevin Marsh & Nicolas Krucien, 2022. "Evaluating the Consistency of Patient Preference Estimates: Systematic Variation in Survival—Adverse Event Trade-Offs in Patients with Cancer or Cardiovascular Disease," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(1), pages 69-75, January.
    14. Lesley Chim & Glenn Salkeld & Patrick Kelly & Wendy Lipworth & Dyfrig A Hughes & Martin R Stockler, 2017. "Societal perspective on access to publicly subsidised medicines: A cross sectional survey of 3080 adults in Australia," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-24, March.
    15. Koonal Shah & Aki Tsuchiya & Allan Wailoo, 2014. "Valuing health at the end of life: an empirical study of public preferences," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(4), pages 389-399, May.
    16. Broqvist, Mari & Sandman, Lars & Garpenby, Peter & Krevers, Barbro, 2018. "The meaning of severity – do citizenś views correspond to a severity framework based on ethical principles for priority setting?," Health Policy, Elsevier, vol. 122(6), pages 630-637.
    17. Martinet, Vincent & Del Campo, Stellio & Cairns, Robert D., 2022. "Intragenerational inequality aversion and intergenerational equity," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, issue forthcomi.
    18. Kaushik Ghosh & Irina Bondarenko & Kassandra L Messer & Susan T Stewart & Trivellore Raghunathan & Allison B Rosen & David M Cutler, 2020. "Attributing medical spending to conditions: A comparison of methods," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-17, August.
    19. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    20. Jeremiah Hurley & Emmanouil Mentzakis & Mita Giacomini & Deirdre DeJean & Michel Grignon, 2017. "Non-market resource allocation and the public’s interpretation of need: an empirical investigation in the context of health care," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 49(1), pages 117-143, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:pophec:v:22:y:2023:i:1:p:76-99. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.