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SUMMARY:Health Economics @ Cambridge seminar: MOVING TOWARDS A SMALLER ROL
 E FOR HEALTH MAXIMISATION IN THE PRIORITISATION OF NHS RESOURCES - Dr Gabr
 iele Badano (University of Cambridge)
DTSTART:20161121T150000Z
DTEND:20161121T160000Z
UID:TALK67026@talks.cam.ac.uk
CONTACT:Ed Wilson
DESCRIPTION:My aim is to criticise a key source of support for an influent
 ial approach to the prioritisation of healthcare resources. This approach\
 , exemplified by NICE’s HTA process\, dictates that resources should be 
 allocated so as to maximise health benefits aggregated throughout the popu
 lation\; at most\, other considerations should be used when maximisation l
 eads to implausible results. \n\nThe influence enjoyed by this approach is
  somewhat puzzling. Not only is the aggregative and maximising approach to
  distribution at the margins of the broader debate in Political Philosophy
 \, but it also clashes with some of the principles of the NHS Constitution
  – most notably\, the principle that access to healthcare must be alloca
 ted based on the needs of individuals.\n\nThis puzzle seems to be explaine
 d by the notion that no approach built on a concern for individual needs c
 an cope with scarcity because it does not know how to prioritise different
  groups of patients in need of healthcare – an influential notion among 
 both health economists and other commentators\, e.g. recently voiced by Al
 bert Weale. According to this notion\, acknowledging scarcity means realis
 ing that any decision has opportunity costs and\, therefore\, that decisio
 n-makers must identify the arrangement that minimises the benefits foregon
 e from other allocations. This minimisation seems to lead naturally to the
  maximisation of aggregate health benefits.\n\nI argue that an approach pr
 imarily focused on individual needs can cope with scarcity. It is enough t
 o extend the idea of opportunity costs so as to include a broader understa
 nding of value\; to minimise the opportunity costs of its decisions\, an a
 gency should aim to minimise the strongest healthcare need that will be le
 ft unattended. This argument opens up new directions for research\, includ
 ing better conceptualisation of how severity\, individual ability to benef
 it and other factors combine to determine healthcare need and the study of
  whether decisions can be based on a prioritised-list approach that ranks 
 available interventions based on need.
LOCATION:Large Seminar Room\, 1st Floor\, Institute of Public Health\, Uni
 versity Forvie Site\, Robinson Way\, Cambridge
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