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The value of health—Empirical issues when estimating the monetary value of a quality‐adjusted life year based on well‐being data

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  • Sebastian Himmler
  • Jannis Stöckel
  • Job van Exel
  • Werner B. F. Brouwer

Abstract

Decisions on interventions or policy alternatives affecting health can be informed by economic evaluations, like cost‐benefit or cost‐utility analyses. In this context, there is a need for valid estimates of the monetary equivalent value of health (gains), which are often expressed in € per quality‐adjusted life years (QALYs). Obtaining such estimates remains methodologically challenging, with a recent addition to the health economists' toolbox, which is based on well‐being data: The well‐being valuation approach. Using general population panel data from Germany, we put this approach to the test by investigating several empirical and conceptual challenges, such as the appropriate functional specification of income utility, the choice of health utility tariffs, or the health state dependence of consumption utility. Depending on specification, the bulk of estimated € per QALY values ranged from €20,000–60,000, with certain specifications leading to more considerable deviations, underlining persistent practical challenges when applying the well‐being valuation methodology to health and QALYs. Based on our findings, we formulate recommendations for future research and applications.

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  • Sebastian Himmler & Jannis Stöckel & Job van Exel & Werner B. F. Brouwer, 2021. "The value of health—Empirical issues when estimating the monetary value of a quality‐adjusted life year based on well‐being data," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1849-1870, August.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:8:p:1849-1870
    DOI: 10.1002/hec.4279
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    1. Dolan, Paul & Kavetsos, Georgios & Krekel, Christian & Mavridis, Dimitris & Metcalfe, Robert & Senik, Claudia & Szymanski, Stefan & Ziebarth, Nicolas R., 2019. "Quantifying the intangible impact of the Olympics using subjective well-being data," Journal of Public Economics, Elsevier, vol. 177(C), pages 1-1.
    2. Etilé, Fabrice & Frijters, Paul & Johnston, David W. & Shields, Michael A., 2020. "Psychological Resilience to Major Socioeconomic Life Events," IZA Discussion Papers 13063, Institute of Labor Economics (IZA).
    3. Philipson Tomas J & Jena Anupam B, 2006. "Who Benefits from New Medical Technologies? Estimates of Consumer and Producer Surpluses for HIV/AIDS Drugs," Forum for Health Economics & Policy, De Gruyter, vol. 9(2), pages 1-33, January.
    4. Sabatini, Fabio, 2014. "The relationship between happiness and health: Evidence from Italy," Social Science & Medicine, Elsevier, vol. 114(C), pages 178-187.
    5. Catherine L. Kling & Daniel J. Phaneuf & Jinhua Zhao, 2012. "From Exxon to BP: Has Some Number Become Better Than No Number?," Journal of Economic Perspectives, American Economic Association, vol. 26(4), pages 3-26, Fall.
    6. Lex Borghans & Angela Lee Duckworth & James J. Heckman & Bas ter Weel, 2008. "The Economics and Psychology of Personality Traits," Journal of Human Resources, University of Wisconsin Press, vol. 43(4).
    7. Bruno S. Frey & Simon Luechinger & Alois Stutzer, "undated". "Valuing Public Goods: The Life Satisfaction Approach," IEW - Working Papers 184, Institute for Empirical Research in Economics - University of Zurich.
    8. Christian Bayer & Falko Juessen, 2015. "Happiness and the Persistence of Income Shocks," American Economic Journal: Macroeconomics, American Economic Association, vol. 7(4), pages 160-187, October.
    9. Huang, Li & Frijters, Paul & Dalziel, Kim & Clarke, Philip, 2018. "Life satisfaction, QALYs, and the monetary value of health," Social Science & Medicine, Elsevier, vol. 211(C), pages 131-136.
    10. Pinto-Prades, Jose-Luis & Sánchez-Martínez, Fernando-Ignacio & Corbacho, Belen & Baker, Rachel, 2014. "Valuing QALYs at the end of life," Social Science & Medicine, Elsevier, vol. 113(C), pages 5-14.
    11. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    12. Pischke, Jörn-Steffen, 2011. "Money and Happiness: Evidence from the Industry Wage Structure," IZA Discussion Papers 5705, Institute of Labor Economics (IZA).
    13. Linda Ryen & Mikael Svensson, 2015. "The Willingness to Pay for a Quality Adjusted Life Year: A Review of the Empirical Literature," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1289-1301, October.
    14. Donna Rowen & Ismail Azzabi Zouraq & Helene Chevrou-Severac & Ben Hout, 2017. "International Regulations and Recommendations for Utility Data for Health Technology Assessment," PharmacoEconomics, Springer, vol. 35(1), pages 11-19, December.
    15. Pischke, Jorn-Steffen & Schwandt, Hannes, 2012. "A Cautionary Note on Using Industry Affiliation to Predict Income," CEPR Discussion Papers 9131, C.E.P.R. Discussion Papers.
    16. McDonald, Rebecca & Powdthavee, Nattavudh, 2018. "The Shadow Prices of Voluntary Caregiving: Using Panel Data of Well-Being to Estimate the Cost of Informal Care," IZA Discussion Papers 11545, Institute of Labor Economics (IZA).
    17. Layard, R. & Mayraz, G. & Nickell, S., 2008. "The marginal utility of income," Journal of Public Economics, Elsevier, vol. 92(8-9), pages 1846-1857, August.
    18. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    19. Dolan, Paul & Olsen, Jan Abel, 2001. "Equity in health: the importance of different health streams," Journal of Health Economics, Elsevier, vol. 20(5), pages 823-834, September.
    20. Luechinger, Simon & Raschky, Paul A., 2009. "Valuing flood disasters using the life satisfaction approach," Journal of Public Economics, Elsevier, vol. 93(3-4), pages 620-633, April.
    21. Bruno Frey & Simon Luechinger & Alois Stutzer, 2009. "The life satisfaction approach to valuing public goods: The case of terrorism," Public Choice, Springer, vol. 138(3), pages 317-345, March.
    22. R. Veenhoven, 2008. "Healthy happiness: effects of happiness on physical health and the consequences for preventive health care," Journal of Happiness Studies, Springer, vol. 9(3), pages 449-469, September.
    23. Loewenstein, George & Ubel, Peter A., 2008. "Hedonic adaptation and the role of decision and experience utility in public policy," Journal of Public Economics, Elsevier, vol. 92(8-9), pages 1795-1810, August.
    24. Simon Luechinger, 2009. "Valuing Air Quality Using the Life Satisfaction Approach," Economic Journal, Royal Economic Society, vol. 119(536), pages 482-515, March.
    25. Paul T E Cusack, 2020. "On Pain," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(3), pages 24253-24254, October.
    26. Ahlert, Marlies & Breyer, Friedrich & Schwettmann, Lars, 2016. "How you ask is what you get: Framing effects in willingness-to-pay for a QALY," Social Science & Medicine, Elsevier, vol. 150(C), pages 40-48.
    27. Oswald, Andrew J. & Powdthavee, Nattavudh, 2008. "Does happiness adapt? A longitudinal study of disability with implications for economists and judges," Journal of Public Economics, Elsevier, vol. 92(5-6), pages 1061-1077, June.
    28. Magne Mogstad & Andres Santos & Alexander Torgovitsky, 2018. "Using Instrumental Variables for Inference About Policy Relevant Treatment Parameters," Econometrica, Econometric Society, vol. 86(5), pages 1589-1619, September.
    29. Paul Frijters & John P. Haisken-DeNew & Michael A. Shields, 2004. "Money Does Matter! Evidence from Increasing Real Income and Life Satisfaction in East Germany Following Reunification," American Economic Review, American Economic Association, vol. 94(3), pages 730-740, June.
    30. Vincenzo Verardi & Christophe Croux, 2009. "Robust regression in Stata," Stata Journal, StataCorp LP, vol. 9(3), pages 439-453, September.
    31. Sebastian Himmler & Job Exel & Werner Brouwer, 2020. "Estimating the monetary value of health and capability well-being applying the well-being valuation approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1235-1244, November.
    32. Ada Ferrer‐i‐Carbonell & Bernard M.S. van Praag, 2002. "The subjective costs of health losses due to chronic diseases. An alternative model for monetary appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 709-722, December.
    33. Dorte Gyrd‐Hansen & Mette Lundsby Jensen & Trine Kjaer, 2014. "Framing The Willingness‐To‐Pay Question: Impact On Response Patterns And Mean Willingness To Pay," Health Economics, John Wiley & Sons, Ltd., vol. 23(5), pages 550-563, May.
    34. Lotte Soeteman & Job Exel & Ana Bobinac, 2017. "The impact of the design of payment scales on the willingness to pay for health gains," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 743-760, July.
    35. Howley, Peter, 2017. "Less money or better health? Evaluating individual’s willingness to make trade-offs using life satisfaction data," Journal of Economic Behavior & Organization, Elsevier, vol. 135(C), pages 53-65.
    36. Kools, Lieke & Knoef, Marike, 2019. "Health and consumption preferences; estimating the health state dependence of utility using equivalence scales," European Economic Review, Elsevier, vol. 113(C), pages 46-62.
    37. Bobinac, Ana & van Exel, N. Job A. & Rutten, Frans F.H. & Brouwer, Werner B.F., 2012. "GET MORE, PAY MORE? An elaborate test of construct validity of willingness to pay per QALY estimates obtained through contingent valuation," Journal of Health Economics, Elsevier, vol. 31(1), pages 158-168.
    38. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
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