Value in health is a concept that has been used in many different contexts. It is used in debates about priority setting, pricing of pharmaceuticals and payment systems. In the Norwegian context, value in health in priority setting is officially defined as the quality-adjusted life-years produced by an intervention. However, the value of an intervention is also adjusted based on the severity of the disease. Importantly, the value does not include gains in productivity. In the context of price setting, there is a movement toward value-based pricing. Although generally supportive, I argue that the approach is limited by noisy and incomplete indicators of outcome and that full value-based pricing of pharmaceuticals has important consequences for the distribution of costs.
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