Lifetime QALY prioritarianism in priority setting

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Journal of Medical Ethics
March 2013, Volume 39, Issue 3
http://jme.bmj.com/content/current

Justice
Paper: Lifetime QALY prioritarianism in priority setting
Trygve Ottersen
J Med Ethics 2013;39:175-180 Published Online First: 30 November 2012 doi:10.1136/medethics-2012-100740

Abstract
Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications.

http://jme.bmj.com/content/39/3/175.abstract