Literature DB >> 9845252

Discounting costs and effects: a reconsideration.

B A van Hout1.   

Abstract

Using a simple societal utility function--giving equal weight to current and future generations-it is concluded that costs need to be discounted on the basis of the expected increase in income and the marginal utility of consumption, and that effects need to be discounted on the basis of the expected increase in health and the marginal utility of health. It is derived that both rates need to be equal when assuming a kind of perfect market, where growth rates are determined by the societal utility function. It is argued that this is an extremely heroic assumption and that different discount rates may be needed. Additionally, the traditional 'inconsistency arguments' of Weinstein and Stason and of Keeler and Cretin are reconsidered. Within the context presented earlier, the first inconsistency only emerges when a growth equilibrium is assumed, reinforcing the arguments put forward before. The Keeler and Cretin paradox is reconsidered by showing that absolutely no paradox emerges when programs are not supposed to stop after a year but are supposed to continue indefinitely. The conclusion is drawn that non-believers in market mechanisms assuring an optimal social policy, need to reconsider the use of their discount rates.

Mesh:

Year:  1998        PMID: 9845252     DOI: 10.1002/(sici)1099-1050(1998110)7:7<581::aid-hec380>3.0.co;2-u

Source DB:  PubMed          Journal:  Health Econ        ISSN: 1057-9230            Impact factor:   3.046


  19 in total

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Review 6.  Valuing prevention through economic evaluation: some considerations regarding the choice of discount model for health effects with focus on infectious diseases.

Authors:  Jasper M Bos; Philippe Beutels; Lieven Annemans; Maarten J Postma
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7.  Discounting health effects in pharmacoeconomic evaluations: current controversies.

Authors:  J M Bos; Maarten J Postma; Lieven Annemans
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8.  Need for differential discounting of costs and health effects in cost effectiveness analyses.

Authors:  Werner B F Brouwer; Louis W Niessen; Maarten J Postma; Frans F H Rutten
Journal:  BMJ       Date:  2005-08-20

9.  Societal discounting of health effects in cost-effectiveness analyses: the influence of life expectancy.

Authors:  Suzanne Polinder; Willem Jan Meerding; Job van Exel; Werner Brouwer
Journal:  Pharmacoeconomics       Date:  2005       Impact factor: 4.981

10.  Modelling downstream effects in the presence of technological change.

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Journal:  Pharmacoeconomics       Date:  2008       Impact factor: 4.981

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