Defining the Value of Medical Interventions
Normative and Empirical Challenges
1st Edition
Published on 10. February 2021
176 pages
978-3-17-038177-3 (ISBN)
Description
Defining the value in health care and elaborating appropriate value-propositions for health care beneficiaries poses numerous empirical and normative challenges. Different methods of Health Technology Assessments (HTAs) embedded in various interdisciplinary approaches of defining the value of health care have been established in recent years. Current initiatives aim to develop and combine transnational attempts to define an overall acceptable range for value-based healthcare interventions.
In this book international scholars with background in medicine, philosophy, health-economics and further disciplines, who participated in an interdisciplinary conference in 2019 combine in-depth analyses with reflections informed by multidisciplinary debates on a pressing issue in healthcare.
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Jan Schildmann | Charlotte Buch | Jürgen Zerth
Defining the Value of Medical Interventions
Normative and Empirical Challenges
Book
02/2021
1st Edition
Kohlhammer
€29.00
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Persons
Jan Schildmann and Charlotte Buch are researchers at the Institute for History and Ethics of Medicine at the Martin Luther University Halle-Wittenberg. Jürgen Zerth is Professor for Health Economics at Wilhelm Loehe University for Applied Science in Fuerth.
Content
- Cover sheet
- Front page
- Imprint
- Table of contents
- Defining the value of medical interventions - a brief introduction
- The Scientific Conference
- The contributions
- 1. Value(s) in healthcare. Introduction and theoretical premises
- 2. Value in healthcare. Interdisciplinary analyses
- 3. Including values and preferences by patients in healthcare. Methods and case studies
- The concepts of 'health' and 'disease'
- Abstract
- 1 Introduction: building the bridge between the concepts of 'health' and 'disease' and the of idea value in medical interventions
- 2 The complexities behind conceptualising health: Its operationalisation and the goals of medicine
- 3 The complexities behind conceptualising disease: what can we learn from key definitions?
- 4 Conclusion: embracing complexity
- References
- Ethical conceptualization of a sustainable right to health(care)
- Abstract
- 1 Outline of the argument
- 2 From the value of health follows a universal right to health and to healthcare
- 2.1 Objectivity of values (cf. Nagel, 1986)
- 2.2 Definition of the right to health as encompassing socioeconomic, environmental, and other rights and a right to healthcare (cf. ICESCR, 1966)
- 2.3 Refutation of arguments against a universal right to healthcare
- 2.4 Agent-neutral and agent-relative right to health(care) (cf. Nagel, 1986)
- 3 From the universal right to health(care) follows a sustainable right to health(care)
- 3.1 Traditional concept of sustainability (cf. WCED, 1987
- Elkington, 1999
- MacDonald and Norman, 2007)
- 3.2 The concept of a sustainable right to health
- 3.3 The concept of a sustainable right to healthcare
- 4 Discussion of the economic aspects of the right to healthcare in consideration of a possible conflict between agent-relative and agent-neutral rights
- 4.1 Selected aspects of the debate on healthcare rationing indifferent countries
- 4.2 Inability to pay as a possible restriction to the right to healthcare?
- 4.3 Disregard for agent-relative rights to healthcare in Porter's economic definition of the value of healthcare (cf. DeCamp, 2019
- Porter, 2010)
- 5 Limitations and implications
- References
- Value(s) in healthcare. Interdisciplinary analyses
- The cost-effectiveness of what in health and care?
- Abstract
- 1 Introduction
- 2 Economic evaluation in health and care: the rationale
- 3 Health economic evaluation: key steps
- 3.1 Defining evaluation perspective
- 3.2 Generating QALYs
- 3.3 Using QALYs to aid decision-making
- 4 An alternative to QALYs based on the Capability Approach
- 4.1 Capability measures
- 4.2 Measuring and valuing capabilities
- 4.3 Using capability measures to aid decision-making
- 5 Summary
- References
- The assessment of value in health economics: utility and capability
- Abstract
- 1 Introduction
- 2 The informational base in conventional health economics
- 3 Broadening the informational base with the capability approach
- 3.1 Amartya Sen and the capability approach
- 3.2 The advantages of using capability over utility
- 4 The need to integrate utility and the capability approach
- 5 Conclusion
- References
- Estimating the monetary value of health: why and how
- Abstract
- 1 Introduction
- 2 Ethics of cost-effectiveness and its decision rule
- 3 Previous approaches for estimating the monetary value of a QALY
- 4 The well-being valuation approach
- 5 Applications of the well-being valuation approach
- 5.1 The value of a QALY and a year in full capability in the UK
- 5.2 The value of a QALY in Germany
- 6 Concluding remarks
- References
- Risk-sharing schemes to finance expensive pharmaceuticals
- Abstract
- 1 Introduction
- 2 Challenges of expensive pharmaceuticals - the impact of a risk-based regulation scheme
- 2.1 Risk-sharing within a value-based regulation approach
- 2.2 Financial-based risk-sharing agreements
- 2.3 Performance-based risk-sharing agreements
- 3 Case example: The multiple sclerosis risk-sharing scheme in the UK
- 4 Discussion
- 4.1 Strengths of PBRSA (in the context of the MS risk-sharing scheme)
- 4.2 Weaknesses (in the context of the MS risk-sharing scheme)
- 5 Conclusion
- References
- Including values and preferences by patients in healthcare. Methods and case studies
- Integrating patients and social aspects into health technology assessment
- Abstract
- 1 Valuation of health technologies
- 1.1 What is health technology assessment?
- 1.2 Recommended domains for a health technology assessment
- 1.3 The HTA Core Model® domain "Patients and Social aspects (SOC)"
- 2. Why include patients and social aspects
- 2.1 The purpose of integrating patients and social aspects
- 2.2 Relevant outcomes for the patients and social aspects domain
- 3 How to include patients and social aspects
- 3.1 Current state of including patients and social aspects
- 3.2 Gathering information
- 3.3 Quality assessment of the studies included
- 3.4 Analysing data on patients and social aspects
- 4 Example: secondary data analysis on patients and social aspects in an HTA on mistletoe therapy in breast cancer patients
- 4.1 Methods
- 4.2 Brief preliminary results
- 4.3 Discussion and challenges
- References
- The shared decision-making model and practical discourse to foster the appreciation of patients' value preferences in Polish healthcare
- Abstract
- 1 Objectives
- 2 Methods
- 3 Background
- 4 Polish healthcare as an institution after the 1989 democratic turn
- 5 Ethical essentials of SDM with relations to discource ethics
- 6 When A, then B? From shared decisions to shared responsibilities
- 7 The appreciation of health and medical values in comparison to SDM in comparison to practical discourse
- 8 How can SDM and practical discourse models be implemented? Sampling cases
- 9 SDM meets Polish healtcare system: open questions
- 10 Conclusions and further research perspectives
- References
- Death or dialysis: the value of burdensome life-extending treatments for the cognitively impaired
- Abstract
- 1 Introduction
- 2 Quality of life
- 3 Bridge therapy
- 4 Is dialysis worth it?
- 5 Conclusion
- References
- Contributors
