Abstract

Background

The value of a statistical life-year (VSLY) is the central number for the economic allocation of health resources. Nevertheless, empirical data on VSLY are lacking for most low- and middle- income countries. In the absence of empirically established VSLY, researchers typically use an arbitrary 3-times multiple of per-capita gross domestic product or per-capita income per life-year saved to establish cost-effectiveness.

Objective

In this study, we establish an empirical VSLY for the first time for a community in sub-Saharan Africa.

Methods

To empirically establish VSLY, we randomly selected 4000 individuals in the Ukonga community of Tanzania and employed a contingent valuation survey to measure VSLY.

Results

We compared our elicited value to per-capita income and found that mean VSLY is $9340 (95% CI $6206-$12 373). The mean annual income in our sample was $2069, resulting in a VSLY that is equivalent to 4.5 times per-capita income.

Conclusion

Our results provide empirical evidence to support moving away from using the World Health Organization cost-effectiveness thresholds in practice because they will likely result in inefficient underinvestment in cost-effective interventions, even in relatively poor samples.