In Defence of QALYs

ABSTRACT A recent article has claimed that one of the significant benefits which people in the UK derive from the existence of the National Health Service must be lost if the Service adopts the QALY maximisation principle to allocate medical resources. The argument fails, partly because its author conflates two distinct benefits. The first is almost certainly important, but there is no reason to believe that it would be lost if the principle were introduced (while there is some reason to believe that the benefit would actually be greater). The second, once it is isolated from others with which it may be confused, is much less obviously important; and in any case there is again no reason to believe that it would be lost. Moreover, to argue against the principle on the ground that the second benefit would disappear is really to beg the question against the principle. We could not justify our rejection of the principle on the ground that the principle's adoption would mean that we lost the second benefit.