Price is not a property of the molecule.
A molecule has a structure. Its price comes later, produced by rules, expectations and relations of power.
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Sustainable for whom?
Sustainable for the budget, for those working in services, for those waiting for treatment: the same word can conceal different accounts.
The patient the model does not see.
The QALY makes comparison possible. The distribution of benefits remains an open question.
The promise before the evidence.
An indicator may anticipate a benefit. How much are we willing to pay while we wait to find out?
The future outside the budget.
We grow used to discussing which treatments we can afford. We less often discuss the conditions that determine the answer.
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