I remember Will bringing this up years ago in Oxford, but it’s good to see the details of the QALY calculation worked out in detail. To generalise somewhat, it seems that because QALYs are bounded between 0 and 1 there’s only limited room for quality-improvements. Instead, issues that involve life-and-death, either by increasing the number of people or their duration, will likely dominate the calculations—in this case the 70-odd QALYs from an entire life dominating the possible QALY-loss due to pregnancy, which is bounded inside [ 0 , 0.75 ].
In particular, QALYs don’t incorporate money, only health. For large changes in health, this isn’t that important, since generally people are willing to pay a lot for health ($50-100k for a 1% decreased chance of dying). In this case, however, the monetary costs of pregnancy might be comparable to the direct health costs.
I remember Will bringing this up years ago in Oxford, but it’s good to see the details of the QALY calculation worked out in detail. To generalise somewhat, it seems that because QALYs are bounded between 0 and 1 there’s only limited room for quality-improvements. Instead, issues that involve life-and-death, either by increasing the number of people or their duration, will likely dominate the calculations—in this case the 70-odd QALYs from an entire life dominating the possible QALY-loss due to pregnancy, which is bounded inside [ 0 , 0.75 ].
Yes—though perhaps this is a limitation in how QALYs are calculated.
In particular, QALYs don’t incorporate money, only health. For large changes in health, this isn’t that important, since generally people are willing to pay a lot for health ($50-100k for a 1% decreased chance of dying). In this case, however, the monetary costs of pregnancy might be comparable to the direct health costs.