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On future non-medical costs in economic evaluations

Liljas, Bengt LU ; Karlsson, Göran S and Stålhammar, Nils-Olov (2008) In Health Economics 17(5). p.579-591
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 lire 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... (More)
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 lire 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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
QALYs, welfare economics, cost-effectiveness analysis, economic evaluation, future costs
in
Health Economics
volume
17
issue
5
pages
579 - 591
publisher
John Wiley & Sons
external identifiers
  • wos:000256249500002
  • scopus:44649183389
ISSN
1099-1050
DOI
10.1002/hec.1279
language
English
LU publication?
yes
id
450165ce-d2cb-48b0-8873-801bb8fac8f8 (old id 1201738)
date added to LUP
2008-09-15 12:48:47
date last changed
2017-01-01 04:40:52
@article{450165ce-d2cb-48b0-8873-801bb8fac8f8,
  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 lire 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.},
  author       = {Liljas, Bengt and Karlsson, Göran S and Stålhammar, Nils-Olov},
  issn         = {1099-1050},
  keyword      = {QALYs,welfare economics,cost-effectiveness analysis,economic evaluation,future costs},
  language     = {eng},
  number       = {5},
  pages        = {579--591},
  publisher    = {John Wiley & Sons},
  series       = {Health Economics},
  title        = {On future non-medical costs in economic evaluations},
  url          = {http://dx.doi.org/10.1002/hec.1279},
  volume       = {17},
  year         = {2008},
}