Complexities of COVID-19 manufacturing

Getting from a mRNA COVID-19 vaccine to scaling to manufacture these vaccines for billions of people is far from simple: Manufacturing mRNA vaccines for the first time in a very short timeframe required significant innovation and remains a technically challenging endeavor. The process proved to be technically challenging as Pfizer developed a 50,000 step process.…

What is wrong with QALYs?

A paper by Rand and Kesselheim (2021) in Health Affairs this month conducts a systematic literature review to answer this question. Based on 113 articles they identified in peer-reviewed journals, they identify the following 10 criticisms categories. The graph above has each criticism category and the number of peer-reviewed articles that mention this critique type.…

Distributional Cost Effectiveness Analysis: A simple example

I have written previously about the need for distributional cost-effectiveness analysis (DCEA) which would increase the value of treatments who improve the health for individuals who currently have the worst expected quality-adjusted life expectancy (QALE). I’ve written about this in AJMC and Health Affairs among other places. One key question many individuals may have is…