Deriving health utilities from the MacNew Heart Disease Quality of Life Questionnaire.

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities.

Paying the right price for pharmaceuticals: a case study of why the comparator matters.

This article considers the pricing policy for pharmaceuticals in Australia, which is widely seen as having achieved low drug prices. However, compared to New Zealand, the evidence implies that Australia might have improved its performance significantly if it had proactively sought market best pricing. The Australian record suggests that the information sought by authorities may not be sufficient for optimal pricing and that the economic evaluation of pharmaceuticals may be neither necessary nor sufficient for achieving this goal.

Severity as an independent determinant of the social value of a health service.

This paper has two objectives, first to review the relevant literature concerning the social importance of severity of pre-treatment condition, and second to present the results of a new analysis of the relationship between social value, individual assessment of health improvement and the severity of illness. The present study differs methodologically from others reported in the literature. The underlying hypothesis is that members of the public have an aversion to patients being in a severe health state irrespective of the reason for their being there, and that this aversion will affect the social valuation of a health program after taking account of the magnitude of the health improvement.

Steering without navigation equipment: the lamentable state of Australian health policy reform.

Background: Commentary on health policy reform in Australia often commences with an unstated logical error: Australians' health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generally self-congratulatory tone of the discussion: a good system needs (relatively) minor improvement.

Results: This paper comments on some issues of particular concern to Australian health policy makers and some areas needing urgent reform.

Priority setting in health care using multi-attribute utility theory and programme budgeting and marginal analysis (PBMA).

Programme budgeting and marginal analysis (PBMA) is becoming an increasingly popular tool in setting health service priorities. This paper presents a novel multi-attribute utility (MAU) approach to setting health service priorities using PBMA. This approach includes identifying the attributes of the MAU function; describing and scaling attributes; quantifying trade-offs between attributes; and combining single conditional utility functions into the MAU function.

Priorities of health policy: cost shifting or population health.

BACKGROUND: This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17-19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. METHODS: Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives.

Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising.