[Should IQWiG revise its methods of cost-effectiveness analysis in order to comply with more widely accepted health economical evaluation standards?].
IQWiG, Germany's equivalent to Britain's National Institute for Health and Clinical Excellence (NICE), has adopted an unorthodox method of cost-effectiveness analysis. The method does not use QALYs (quality adjusted life years). Its main point is that it tries to avoid comparative judgement on the relative value of treatment effects in different medical areas. The present contribution assesses the controversy that has arisen over IQWiG's methods by discussing a) whether comparative judgements will at least implicitly be made anyway as soon as the IQWiG makes reimbursement recommendations in more than one medical area, and b) whether the well-known fairness objections against QALY maximization can plausibly be dealt with by equity weigthing or, generally, by moving on to "societal value" maximization, which tries to include fairness values in addition to cost-effectiveness. It is concluded that the answer is "No" for both points, which leads to a "No" for the title question as well.
Institut für Philosophie, Universität Regensburg. weyma.luebbe@psk.uniregensburg.de
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D003362:Cost-Benefit Analysis / Q000379:methods* / Q000592:standards*; D005858:Germany; D017059:Models, Econometric; D017410:Practice Guidelines as Topic; D019057:Quality-Adjusted Life Years
Sollte sich das IQWiG auf indikationsübergreifende Kosten-Nutzen-Bewertungen mittels des QALY-Konzepts einlassen?