Discounting Health Outcomes in Economic Evaluation- The Ongoing Debate

Discounting is a mathematical procedure for adjusting future costs and outcomes of health- care interventions to “present value”; essentially this means adjusting for differences in the timing of costs (expenditure) compared to health benefits (outcomes). Calculations for discounting are straightforward: for each year (n) in the future the value of costs or benefits is multiplied by (1/(1+D)n) where D is the discount rate [1]. Higher discount rates or longer delays produce lower net present value. A constant discount rate produces values that decline exponentially with time.