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After all, human life does have a price. Around the world, governments calculate a maximum value for the cost of “one year of healthy life”, and above this cost, which varies from country to country, medical treatments are not financed. But this calculation has a fundamental flaw.
All governments face the need to do the same brutal calculation: When healthcare budgets are limited, how to decide which medical treatments to fund and which ones to refuse?
For decades, government response has been a numbera price established by a year of perfect health.
In Japan, this number is around 5 million yen — about 30 thousand euros. A treatment that costs more per healthy year gained is normally rejectedone that costs less is approved.
In a new study, researchers from the Tokyo University of Science now argue that this traditional approach contains a fundamental flaw: a year of good health at age 25 does not have the same economic weight than a year at 85.
Support the opposite of this evidence silently distorts the way medical resources are distributed in a aging populationhighlights the .
In yours, published at the beginning of the month in the magazine Scientific Reportsa team led by professor Ryuta Takashima built a model that adjusts the value of a quality-adjusted life year (QALY) based on age and realistic health trajectories.
The researchers calculated how this value changes throughout the different stages of life using Japan salary dataconsumption patterns and survival rates.
According to the results of the study, the value of a QALY increases effectively with age. For someone in your 20san additional healthy year could be worth between 3 to 4 million yenes. For someone in their 80s, that same year might exceed 9 million yen.
The difference is partly due to “temporal discount” (future gains are worth less than immediate gains), but also to the way older adults benefit more directly from extending life expectancy.
To make their estimates realistic, the researchers modeled how the quality of life typically changes over a lifetime.
A scenario assumes a slow and steady decline after age 50. Another reflects a sharp drop in health at 60perhaps due to chronic illnesses, followed by stabilization.
A third scenario envisages gradual deterioration over a lifetime. The room represents a relatively stable health until an abrupt decline near the end.
By applying these scenarios to economic models based on the value of a life statistical (a standard measure of what society is willing to pay to reduce mortality risk), the team calculated age-specific QALY values for each trajectory. In all four scenarios, the pattern remained: older people, higher value per healthy year.
Policies currently pursued by governments may, as a result, be silently bias decisions.
Use a fixed QALY threshold can lead to rejection of cost-effective interventions for older adults while endorsing other interventions, inefficient for younger populations. In an aging society, this distortion becomes worse.
The investigation also reveals something less obvious. When populations maintain better health for longer, the monetary value of an additional year of perfect health actually decreases. Not because health matters less, but because the gains are contribute to a longer and healthier life.
In populations where people remain robust until old age, adding another year provides a smaller marginal benefit than in those where the decline starts earlier.
Investments that successfully extend the healthy life expectancy they can reduce global healthcare costseven as people live longer. When more individuals follow healthier aging trajectories, governments achieve population health gains at a lower cost per QALY. Prevention changes the economic baseline.
“Our findings help clarify the value of prolonging healthy life according to quality of life and age, making it possible to present measures for the rational allocation of medical resources”, explains Takashima.
The study does not argue that some lives matter more than others; shows how gross assumptions have repercussions on financing decisions, silently shaping which treatments are approved.
In a future defined by longer lives and limited budgets, a more flexible view of what a healthy year is worth could help policymakers manage aging. not as an inevitable cost, but as a variable that they can shape.
