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The European Journal of Health Economics

pp 1–10

First Online: 01 June 2017Received: 25 November 2016Accepted: 11 May 2017DOI: 10.1007-s10198-017-0897-3

Cite this article as: Round, J. & Paulden, M. Eur J Health Econ 2017. doi:10.1007-s10198-017-0897-3


In publicly funded health care systems, decision makers must continually balance often conflicting priorities of efficiency and equity. Health economists have developed a set of highly sophisticated analytical methods for assessing efficiency, but less attention has been paid to formally incorporating equity considerations into analyses. As a result, where equity is considered is often informal, ad hoc and-or simplistic. This paper is a proposal for a mechanism for formally incorporating equity within the decision process. It begins with an overview of the current literature on equity weighting. It then considers the case of a single equity domain and illustrates how this is currently applied in practice by the UK’s National Institute for Health and Care Excellence. It then proposes a more comprehensive method for considering the multi-attribute equity state, where a population exhibits more than one trait considered worthy of differential weighting. Finally, the paper proposes a mechanism by which this could be applied in practice, and concludes with a discussion of the challenges for applying multi-attribute equity weighting.

KeywordsEquity Equity weights Distributional weights Cost-effectiveness Electronic supplementary materialThe online version of this article doi:10.1007-s10198-017-0897-3 contains supplementary material, which is available to authorized users.

JEL ClassificationI1 Health I10 General I14 Health and Inequality I18 Government Policy, Regulation, Public Health I19 Other 

Autor: Jeff Round - Mike Paulden


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