Understanding Harris' understanding of CEA: is cost effective resource allocation undone?

Richard Edlin; Christopher McCabe; Jeff Round; Judy Wright; Karl Claxton; Mark Sculpher; Richard Cookson

doi:10.1258/jhsrp.2012.011057

Understanding Harris' understanding of CEA: is cost effective resource allocation undone?

Richard Edlin, Christopher McCabe, Jeff Round, Judy Wright, Karl Claxton, Mark Sculpher, Richard Cookson

Research output: Contribution to journal › Article › peer-review

Abstract

We summarise and evaluate Harris' criticisms of cost-effectiveness analysis (CEA) and the alternative processes he commends to health care decision makers. In contrast to CEA, Harris' asserts that individuals have a right to life-saving treatment that cannot be denied on the basis of their capacity to benefit. We conclude that, whilst Harris' work has challenged the proponents of CEA and quality-adjusted life years to be explicit about the method's indirect discriminatory characteristics, his arguments ignore important questions about what 'lives saved' mean. Harris also attempts to avoid opportunity cost by advocating the same chance of treatment for every person desiring treatment. Using a simple example, we illustrate that an 'equal chances' lottery is not in the interest of any patient, as it reduces the chance of treatment for all patients by leaving some of the health budget unspent.

Original language	English
Pages (from-to)	34-39
Number of pages	6
Journal	Journal of Health Services Research & Policy
Volume	18
Issue number	1
DOIs	https://doi.org/10.1258/jhsrp.2012.011057
Publication status	Published - Jan 2013

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10.1258/jhsrp.2012.011057

http://hsr.sagepub.com/content/18/1/34

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title = "Understanding Harris' understanding of CEA: is cost effective resource allocation undone?",

abstract = "We summarise and evaluate Harris' criticisms of cost-effectiveness analysis (CEA) and the alternative processes he commends to health care decision makers. In contrast to CEA, Harris' asserts that individuals have a right to life-saving treatment that cannot be denied on the basis of their capacity to benefit. We conclude that, whilst Harris' work has challenged the proponents of CEA and quality-adjusted life years to be explicit about the method's indirect discriminatory characteristics, his arguments ignore important questions about what 'lives saved' mean. Harris also attempts to avoid opportunity cost by advocating the same chance of treatment for every person desiring treatment. Using a simple example, we illustrate that an 'equal chances' lottery is not in the interest of any patient, as it reduces the chance of treatment for all patients by leaving some of the health budget unspent.",

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AU - Wright, Judy

AU - Claxton, Karl

AU - Sculpher, Mark

AU - Cookson, Richard

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