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On future non-medical costs in economic evaluations

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Author Info
Bengt Liljas
Göran S. Karlsson (AstraZeneca Sverige, Södertälje, Sweden)
Nils-Olov Stålhammar
Abstract

Economic evaluation in health care is still an evolving discipline. One of the current controversies in cost-effectiveness analysis regards the inclusion or exclusion of future non-medical costs (i.e. consumption net of production) due to increased survival. This paper examines the implications of a symmetry rule stating that there should be consistency between costs included in the numerator and utility aspects included in the denominator. While the observation that no quality-adjusted life year (QALY) instruments explicitly include consumption and leisure seems to give support to the notion that future non-medical costs should be excluded when QALYs are used as the outcome measure, a better understanding of what respondents actually consider when reporting QALY weights is required. However, the more fundamental question is whether QALYs can be interpreted as utilities. Or more precisely, what are the assumptions needed for a general utility model also including consumption and leisure to be consistent with QALYs? Once those assumptions are identified, they need to be experimentally tested to see whether they are at least approximately valid. Until we have answers to these areas for future research, it seems premature to include future non-medical costs. Copyright © 2007 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1279
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 5 ()
Pages: 579-591
Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
Handle: RePEc:wly:hlthec:v:17:y:2008:i:5:p:579-591

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  1. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February. [Downloadable!] (restricted)
  2. Braden Manns & David Meltzer & Ken Taub & Cam Donaldson, 2003. "Illustrating the impact of including future costs in economic evaluations: an application to end-stage renal disease care," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 949-958. [Downloadable!]
  3. Meltzer, David, 1997. "Accounting for future costs in medical cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 33-64, February. [Downloadable!] (restricted)
  4. Bleichrodt, Han & Quiggin, John, 1999. "Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis?," Journal of Health Economics, Elsevier, vol. 18(6), pages 681-708, December. [Downloadable!] (restricted)
  5. Afschin Gandjour, 2006. "Consumption costs and earnings during added years of life - a reply to Nyman," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 315-317. [Downloadable!]
  6. Dolan, Paul, 2000. "The measurement of health-related quality of life for use in resource allocation decisions in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 32, pages 1723-1760 Elsevier. [Downloadable!] (restricted)
  7. Weinstein, Milton C. & Manning, Willard Jr., 1997. "Theoretical issues in cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 121-128, February. [Downloadable!] (restricted)
  8. Dorte Gyrd-Hansen & Jes Søggard & Ole Kronborg, 1998. "Colorectal cancer screening: efficiency and effectiveness," Health Economics, John Wiley & Sons, Ltd., vol. 7(1), pages 9-20.
  9. David Meltzer, 1997. "Accounting for Future Costs in Medical Cost-Effectiveness Analysis," NBER Working Papers 5946, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  10. Garber, Alan M., 2000. "Advances in cost-effectiveness analysis of health interventions," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 4, pages 181-221 Elsevier. [Downloadable!] (restricted)
  11. Bush, J. W. & Fanshel, S. & Chen, M. M., 1972. "Analysis of a tuberculin testing program using a health status index," Socio-Economic Planning Sciences, Elsevier, vol. 6(1), pages 49-68, February. [Downloadable!] (restricted)
  12. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39.
  13. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
  14. Garber, Alan M. & Phelps, Charles E., 1997. "Economic foundations of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 1-31, February. [Downloadable!] (restricted)
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