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REFLECTIONS ON THE NICE DECISION TO REJECT PATIENT PRODUCTION LOSSES

Part of: Special Collection - Methods

Published online by Cambridge University Press:  20 November 2017

James Shearer ,
Sarah Byford  and
Steve Birch
James Shearer
Affiliation:
King's Health Economics, King's College Londonjames.shearer@kcl.ac.uk
Sarah Byford
Affiliation:
King's Health Economics, King's College London
Steve Birch
Affiliation:
Centre for Health Economics and Policy Analysis (CHEPA) McMaster University
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Abstract

Objectives: Patient production losses occur when individuals’ capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions.

Methods: A narrative review was undertaken of theoretical, ethical, and policy issues that might inform decisions that involve the normative question of whether or not to include patient production losses in economic evaluation.

Results: It seems difficult to reconcile the implications of including patient production losses with the objectives of a healthcare system dedicated to providing universal healthcare coverage without regard to patients’ ability to pay.

Conclusions: Tax payer funded healthcare systems may legitimately adopt maximands other than health gain, but these will be at the opportunity cost of less than maximum health gains.

Keywords

Production lossesEconomic evaluationHealth policy
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 6 , 2017 , pp. 638 - 643
Copyright
Copyright © Cambridge University Press 2017 

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