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Life at a Premium: Considering an End-of-Life Premium in Value-Based Reimbursement

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Care at the End of Life

Abstract

The increasingly explicit use of health technology assessment (HTA) continues to generate substantial public and academic policy debates. One specific issue, which raises a host of concerns, is whether it is proper to treat the benefits of treatment for patients close to the ends of their lives relatively favourably. This might be done by, for example, weighting their benefits more heavily or their costs more lightly than those accruing to other patient groups or by using differential discount (interest) rates or by applying an ‘easier’ threshold condition for the technology in question to be approved. This chapter considers whether it is possible to develop a theoretically coherent, procedurally transparent and inter-decision-consistent value framework to inform reimbursement decisions. This chapter describes the landscape in which the debates for such a framework are taking place and critically evaluates the claims made by different groups for different value premiums from a conceptual and empirical perspective.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada

    Christopher McCabe & Mike Paulden

  2. Trinity College Dublin, Dublin, Ireland

    James O’Mahony

  3. School of Population, University of Auckland, Auckland, New Zealand

    Richard Edlin

  4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Anthony Culyer

  5. Centre for Health Economics, University of York, York, UK

    Anthony Culyer

Authors
  1. Christopher McCabe
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  2. Mike Paulden
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  3. James O’Mahony
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  4. Richard Edlin
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  5. Anthony Culyer
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Corresponding author

Correspondence to Christopher McCabe .

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Editors and Affiliations

  1. UCL Comprehensive Clinical Trials Unit, Principal Research Associate, London, United Kingdom

    Jeff Round

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McCabe, C., Paulden, M., O’Mahony, J., Edlin, R., Culyer, A. (2016). Life at a Premium: Considering an End-of-Life Premium in Value-Based Reimbursement. In: Round, J. (eds) Care at the End of Life. Adis, Cham. https://doi.org/10.1007/978-3-319-28267-1_9

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