Normative foundations for equity-sensitive population health evaluation functions

Abstract

Standard models for the evaluation of population health, such as the so-called models of aggregate Quality Adjusted Life Years (QALYs), or aggregate Healthy Years Equivalent (HYEs), are usually criticized on equity grounds. We provide in this paper normative justifications for alternative equitysensitive models, such as the so-called models of multiplicative QALYs, multiplicative HYEs, and generalizations of the two. Our axiomatic approach assumes social preferences over distributions of individual health states experienced in a given period of time. It conveys informational simplicity, as it does not require information about individual preferences on health.