✦ LIBER ✦

Discounting and health benefits

✍ Scribed by Michael Parsonage; Henry Neuburger

Publisher: John Wiley and Sons
Year: 1992
Tongue: English
Weight: 528 KB
Volume: 1
Category: Article
ISSN: 1057-9230
DOI: 10.1002/hec.4730010110

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✦ Synopsis

In each issue of the Journal we shall address an issue of particular concern in the development of health economics and on which there is no consensus within the profession. These articles are published to stimulate debate and to encourage new thinking. Responses are invited in the form of letters to the Editors, comments, notes or full length articles which can be published in this section in future issues of the Journal.

The first issue raised is the question of discounting health benefits. In the first paper, Neuburger and Parsonage argue that there is no justification for the current practice in economic evaluation of health programmes of discounting both the costs and benefits at the same rate. This is relevant to current policy discussions on the comparative effectiveness of programmes giving immediate or delayed health gains. Cairns offers a different perspective and provides a conceptual and practical critique of Neuburger and Parsonage's views.

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✍ John Cairns 📂 Article 📅 1992 🏛 John Wiley and Sons 🌐 English ⚖ 290 KB

This paper reviews the argument advanced by Parsonage and Neuburger that the non-monetary benefits of health programmes should be discounted at a lower rate than that used for financial flows. The conceptual issues raised in that paper are discussed and others, such as the tradability of non-monetar

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In economic evaluation of health care, main stream practice is to discount benefits at the same rate as costs. But main papers in which this practice is advocated have missed a distinction between two quite different evaluation problems: (1) How much does the time of program occurrence matter for va

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## Abstract When health effects can be valued in monetary terms, as in cost–benefit analysis, they should be discounted at the same rate as costs. If health effects are measured in quantities (e.g. quality adjusted life years) as in cost‐effectiveness analysis (CEA) and the value of health effects

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Statistical and conceptual difficulties complicate the estimation of the incremental cost-effectiveness ratio (ICER). An alternative approach is to measure cost-effectiveness by the incremental net health benefit (INHB), defined as the difference in mean effectiveness of a new treatment compared wit

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## SUMMARY Nord (2011) criticizes standard arguments which assert that consistency requires that future health benefits must be discounted at the same rate as future costs in cost‐effectiveness analysis (CEA). He suggests these arguments are misguided because they require transitivity of preference