Of course, this violates the assumption of a constant WTP-per-QALY, as programmes
focusing on the rich generate greater benefits to society for an equal number of QALYs
than those focused on the poor. Johannesson and Meltzer seek to avoid this by assuming
that incomes are constant across society. As income is the only non-health factor in PZ’s
model, there can be no interaction between health and non-health factors, and so the model
is consistent with the health focus of CEA. However, the reliance on a point distribution for
income necessarily places the status of any link between CBA and CEA in doubt.We begin
by developing PZ’s model to incorporate life expectancy and quality of life. Following PZ,
we assume that there are no interpersonal aspects to utility, so that social WTP corresponds
to individual WTP because individuals are unconcerned with the health of others.3 We
then find the conditions under which a constant societal WTP-per-QALY holds when the
unrealistic constant income assumption is relaxed.
Of course, this violates the assumption of a constant WTP-per-QALY, as programmesfocusing on the rich generate greater benefits to society for an equal number of QALYsthan those focused on the poor. Johannesson and Meltzer seek to avoid this by assumingthat incomes are constant across society. As income is the only non-health factor in PZ’smodel, there can be no interaction between health and non-health factors, and so the modelis consistent with the health focus of CEA. However, the reliance on a point distribution forincome necessarily places the status of any link between CBA and CEA in doubt.We beginby developing PZ’s model to incorporate life expectancy and quality of life. Following PZ,we assume that there are no interpersonal aspects to utility, so that social WTP correspondsto individual WTP because individuals are unconcerned with the health of others.3 Wethen find the conditions under which a constant societal WTP-per-QALY holds when theunrealistic constant income assumption is relaxed.
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