Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.
Department of Economics, KU Leuven, Leuven, Belgium.
Health Econ. 2022 Jan;31(1):258-265. doi: 10.1002/hec.4454. Epub 2021 Nov 7.
Sometimes healthcare will affect the health of people living in the future, or their chance of coming into existence. Should such outcomes be valued in health-economic evaluation? Guidelines implicitly recommend their inclusion but this rule has counterintuitive implications and is not consistently applied in practice. We suggest making a distinction between "necessary" and "potential" future lives in Health Technology Assessment. Necessary lives will exist independent of our healthcare choices and should be included. Potential lives are choice-dependent and should be excluded. This rule offers intuitive solutions within the HTA framework, and it changes the cost-effectiveness of several interventions where necessary future lives are affected.
有时，医疗保健会影响未来生活在这个世界上的人的健康，或者影响他们的存在机会。在健康经济评估中，这些结果是否应该被重视？指南隐含地建议将其包括在内，但这条规则有违直觉，在实践中也没有得到一致应用。我们建议在卫生技术评估中对“必要”和“潜在”未来生命进行区分。必要的生命将独立于我们的医疗保健选择而存在，应该被包括在内。潜在的生命是取决于选择的，应该被排除在外。这条规则在 HTA 框架内提供了直观的解决方案，并且改变了一些必要未来生命受到影响的干预措施的成本效益。
