Did We Follow the Right Approach in Economic Evaluations By Discounting Health Gain?
Author(s)
Ethgen O1, Standaert B2
1University of Liège, Liège, Belgium, 2Hasselt University, Antwerp, Belgium
OBJECTIVES: Discounting health is routinely applied in health economic evaluations causing debates about its appropriate level and whether it should be equivalent or lower than discounting cost. Different fundamental arguments were put forward to keep the discount rate for health the same as for cost. Differential discounting may cause inconsistencies in the interpretation of the results or may cause paradoxes in initiating prevention. The question we have however is different, is health gain a suitable measure to be discounted like money is?
METHODS: Looking at economic assessments of consumable goods, discounting is only applied to the monetary value. Money is a flexible instrument for trading purposes, but subject to value changes over time. With money, product value can be expressed with value-based pricing processes the consumer is willing to pay. Money is then discounted in that process because its amount allows to do other things within different time periods. However, the outcomes of the processes that can be instantaneous or continuous such as energy (joules), distance travelled (km), cooling periods (temperature), are not part of the discounting if the outcome is produced over a long duration period.
RESULTS: In health economics of new interventions brought into the market, values are presented with an obliged discount for the heath outcome that could however be considered equivalent to energy, travelled distance, cooling periods, and the like. We are presenting a list of comparative conditions between the economic assessment of consumable goods versus the situation in healthcare in which paradoxical conditions are highlighted especially related to the situation of vaccine prevention.
CONCLUSIONS: This analysis should give us the right arguments that health gain is not a suitable outcome measure for being discounted.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EE595
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
STA: Vaccines