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The (Ir)relevance of Group Size in Health Care Priority Setting: A Reply to Juth
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. University of Borås, Sweden.
Linköping University, Department of Culture and Communication, Arts and Humanities. Linköping University, Faculty of Arts and Sciences.
2017 (English)In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 25, no 1, 21-33 p.Article in journal (Refereed) Published
Abstract [en]

How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze Juths argument and observe that we already do compensate for indirectly operative factors, both outside and within cost-effectiveness evaluations, for formal equality reasons. Based on this we argue that we have reason to set cost-effectiveness thresholds to integrate equity concerns also including formal equality considerations. We find no reason not to compensate for group size to the extent we already compensate for other factors. Moreover, groups size implying a systematic disadvantage also on a global scale, i.e. taking different aspects of the health condition of patients suffering from rare diseases into account, will provide strong reason for why group size is indeed relevant to compensate for (if anything).

Place, publisher, year, edition, pages
SPRINGER , 2017. Vol. 25, no 1, 21-33 p.
Keyword [en]
Priority setting; Orphan drugs; Rare diseases; Equality; Formal equality; Justice; Cost-effectiveness
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-136654DOI: 10.1007/s10728-016-0333-3ISI: 000395099900002PubMedID: 27734213OAI: oai:DiVA.org:liu-136654DiVA: diva2:1089830
Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-05-08

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