Abstract

Defining the value in health care and elaborating appropriate value-propositions for health care beneficiaries poses numerous empirical and normative challenges. Different methods of Health Technology Assessments (HTAs) embedded in various interdisciplinary approaches of defining the value of health care have been established in recent years. Current initiatives aim to develop and combine transnational attempts to define an overall acceptable range for value-based healthcare interventions. In this book international scholars with background in medicine, philosophy, health-economics and further disciplines, who participated in an interdisciplinary conference in 2019 combine in-depth analyses with reflections informed by multidisciplinary debates on a pressing issue in healthcare.

Contents

• Versorgung gestalten – Gestaltung der Gesundheits- und Sozialversorgung heute und morgen
  Jürgen Zerth and Elmar Nass.
• Value(s) in healthcare. Introduction and theoretical premises
  • Defining the value of medical interventions – a brief introduction
    Editors: Jan Schildmann, Charlotte Buch, and Jürgen Zerth.
    • The Scientific Conference
    • The contributions
  • The concepts of ‘health’ and ‘disease’: Underlying assumptions in the idea of value in medical interventions
    Francisca Stutzin Donoso.
    • 1. Introduction: building the bridge between the concepts of ‘health’ and ‘disease’ and the of idea value in medical interventions
    • 2. The complexities behind conceptualising health: Its operationalisation and the goals of medicine
    • 3. The complexities behind conceptualising disease: what can we learn from key definitions?
    • 4. Conclusion: embracing complexity
    • References
  • Ethical conceptualization of a sustainable right to health(care)
    Karla Alex.
    • 1. Outline of the argument
    • 2. From the value of health follows a universal right to health and to healthcare
    • 3. From the universal right to health(care) follows a sustainable right to health(care)
    • 4. Discussion of the economic aspects of the right to healthcare in consideration of a possible conflict between agent-relative and agent-neutral rights
    • 5. Limitations and implications
    • Acknowledgments
    • References
• Value(s) in healthcare. Interdisciplinary Analyses
  • The cost-effectiveness of what in health and care?
    Paul Mark Mitchell.
    • 1. Introduction
    • 2. Economic evaluation in health and care: the rationale
    • 3. Health economic evaluation: key steps
    • 4. An alternative to QALYs based on the Capability Approach
    • 5. Summary
    • Acknowledgements
    • References
  • The assessment of value in health economics: utility and capability
    Jasper Ubels.
    • 1. Introduction
    • 2. The informational base in conventional health economics
    • 3. Broadening the informational base with the capability approach
    • 4. The need to integrate utility and the capability approach
    • 5. Conclusion
    • References
  • Estimating the monetary value of health: why and how
    Sebastian Himmler.
    • 1. Introduction
    • 2. Ethics of cost-effectiveness and its decision rule
    • 3. Previous approaches for estimating the monetary value of a QALY
    • 4. The well-being valuation approach
    • 5. Applications of the well-being valuation approach
    • 6. Concluding remarks
    • Acknowledgements
    • References
  • Risk-sharing schemes to finance expensive pharmaceuticals: Interdisciplinary analyses
    Charlotte Buch, Jan Schildmann, and Jürgen Zerth.
    • 1. Introduction
    • 2. Challenges of expensive pharmaceuticals – the impact of a risk-based regulation scheme
    • 3. Case example: The multiple sclerosis risk-sharing scheme in the UK
    • 4. Discussion
    • 5. Conclusion
    • References
• Including values and preferences by patients in healthcare. Methods and case studies
  • Integrating patients and social aspects into health technology assessment
    Caroline Steigenberger, Petra Schnell-Inderst, and Uwe Siebert.
    • 1. Valuation of health technologies
    • 2. Why include patients and social aspects
    • 3. How to include patients and social aspects
    • 4. Example: secondary data analysis on patients and social aspects in an HTA on mistletoe therapy in breast cancer patients
    • References
  • The shared decision-making model and practical discourse to foster the appreciation of patients’ value preferences in Polish healthcare: Discussing potentials and challenges
    Karolina Napiwodzka.
    • 1. Objectives
    • 2. Methods
    • 3. Background
    • 4. Polish healthcare as an institution after the 1989 democratic turn
    • 5. Ethical essentials of SDM with relations to discource ethics
    • 6. When A, then B? From shared decisions to shared responsibilities
    • 7. The appreciation of health and medical values in comparison to SDM in comparison to practical discourse
    • 8. How can SDM and practical discourse models be implemented? Sampling cases
    • 9. SDM meets Polish healtcare system: open questions
    • 10. Conclusions and further research perspectives
    • References
  • Death or dialysis: the value of burdensome life-extending treatments for the cognitively impaired
    Jordan A. Parsons.
    • 1. Introduction
    • 2. Quality of life
    • 3. Bridge therapy
    • 4. Is dialysis worth it?
    • 5. Conclusion
    • References
• Contributors