IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v36y2018i7d10.1007_s40273-018-0672-z.html
   My bibliography  Save this article

Discounting in Economic Evaluations

Author

Listed:
  • Arthur E. Attema

    (Erasmus University Rotterdam)

  • Werner B. F. Brouwer

    (Erasmus University Rotterdam)

  • Karl Claxton

    (University of York)

Abstract

Appropriate discounting rules in economic evaluations have received considerable attention in the literature and in national guidelines for economic evaluations. Rightfully so, as discounting can be quite influential on the outcomes of economic evaluations. The most prominent controversies regarding discounting involve the basis for and height of the discount rate, whether costs and effects should be discounted at the same rate, and whether discount rates should decline or stay constant over time. Moreover, the choice for discount rules depends on the decision context one adopts as the most relevant. In this article, we review these issues and debates, and describe and discuss the current discounting recommendations of the countries publishing their national guidelines. We finish the article by proposing a research agenda.

Suggested Citation

  • Arthur E. Attema & Werner B. F. Brouwer & Karl Claxton, 2018. "Discounting in Economic Evaluations," PharmacoEconomics, Springer, vol. 36(7), pages 745-758, July.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:7:d:10.1007_s40273-018-0672-z
    DOI: 10.1007/s40273-018-0672-z
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-018-0672-z
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40273-018-0672-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. John Cairns, 1992. "Discounting and health benefits: Another Perspective," Health Economics, John Wiley & Sons, Ltd., vol. 1(1), pages 76-79, April.
    2. van der Pol, Marjon & Cairns, John, 2001. "Estimating time preferences for health using discrete choice experiments," Social Science & Medicine, Elsevier, vol. 52(9), pages 1459-1470, May.
    3. Arthur E. Attema & Werner B. F. Brouwer, 2008. "Can we fix it? Yes we can! But what? A new test of procedural invariance in TTO‐measurement," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 877-885, July.
    4. Hugh Gravelle & Werner Brouwer & Louis Niessen & Maarten Postma & Frans Rutten, 2007. "Discounting in economic evaluations: stepping forward towards optimal decision rules," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 307-317, March.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    6. Emmett B. Keeler & Shan Cretin, 1983. "Discounting of Life-Saving and Other Nonmonetary Effects," Management Science, INFORMS, vol. 29(3), pages 300-306, March.
    7. Robberstad, Bjarne, 2005. "Estimation of private and social time preferences for health in northern Tanzania," Social Science & Medicine, Elsevier, vol. 61(7), pages 1597-1607, October.
    8. Hugh Gravelle & Dave Smith, 2001. "Discounting for health effects in cost–benefit and cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 587-599, October.
    9. Angelina Lazaro & Ramon Barberan & Encarnacion Rubio, 2001. "Private and social time preferences for health and money: an empirical estimation," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 351-356, June.
    10. Jan Abel Olsen, 1993. "Time preferences for health gains: An empirical investigation," Health Economics, John Wiley & Sons, Ltd., vol. 2(3), pages 257-265, October.
    11. Han Bleichrodt, 2002. "A new explanation for the difference between time trade‐off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456, July.
    12. Ben A. Van Hout, 1998. "Discounting costs and effects: a reconsideration," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 581-594, November.
    13. Karl Claxton & Mark Sculpher & Anthony Culyer & Chris McCabe & Andrew Briggs & Ron Akehurst & Martin Buxton & John Brazier, 2006. "Discounting and cost‐effectiveness in NICE – stepping back to sort out a confusion," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 1-4, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lars Hultkrantz, 2021. "Discounting in economic evaluation of healthcare interventions: what about the risk term?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 357-363, April.
    2. Himmler, Sebastian & Jonker, Marcel & van Krugten, Frédérique & Hackert, Mariska & van Exel, Job & Brouwer, Werner, 2022. "Estimating an anchored utility tariff for the well-being of older people measure (WOOP) for the Netherlands," Social Science & Medicine, Elsevier, vol. 301(C).
    3. Sujata Behera, 2020. "Does the EVA valuation model explain the market value of equity better under changing required return than constant required return?," Financial Innovation, Springer;Southwestern University of Finance and Economics, vol. 6(1), pages 1-23, December.
    4. Klas Kellerborg & Werner Brouwer & Pieter Baal, 2020. "Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1329-1350, December.
    5. Ali Tafazzoli & Odette S. Reifsnider & Leana Bellanca & Jack Ishak & Marc Carrasco & Pal Rakonczai & Matthew Stargardter & Stephan Linden, 2023. "A European multinational cost-effectiveness analysis of empagliflozin in heart failure with reduced ejection fraction," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(9), pages 1441-1454, December.
    6. Elahe Khorasani & Majid Davari & Abbas Kebriaeezadeh & Farshad Fatemi & Ali Akbari Sari & Vida Varahrami, 2022. "A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1577-1590, December.
    7. Silke Gabbert & Arianne de Blaeij & Joris T. K. Quik & Joost Bakker & Joop de Knecht & Eric Verbruggen & Richard Luit, 2023. "Can cost‐effectiveness analysis of control measures for persistent chemicals be improved? A critical evaluation of approaches for assessing “effectiveness”," Journal of Industrial Ecology, Yale University, vol. 27(1), pages 155-169, February.
    8. Steve Harris & Jan Weinzettel & Gregor Levin, 2020. "Implications of Low Carbon City Sustainability Strategies for 2050," Sustainability, MDPI, vol. 12(13), pages 1-23, July.
    9. Kimberly M. Thompson & Dominika A. Kalkowska, 2021. "Potential Future Use, Costs, and Value of Poliovirus Vaccines," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 349-363, February.
    10. Tim Colbourn, 2024. "Evaluation 2 of "Accelerating Vaccine Innovation for Emerging Infectious Diseases via Parallel Discovery"," The Unjournal Evaluations 2024-12, The Unjournal.
    11. Stefan A. Lipman & Arthur E. Attema, 2024. "A systematic review of unique methods for measuring discount rates," Journal of Risk and Uncertainty, Springer, vol. 69(2), pages 145-189, October.
    12. Admassu N. Lamu & Ole F. Norheim & Fredrik A. Gregersen & Mathias Barra, 2021. "Cycle‐network expansion plan in Oslo: Modeling cost‐effectiveness analysis and health equity impact," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3220-3235, December.
    13. Kellerborg, Klas & Wouterse, Bram & Brouwer, Werner & van Baal, Pieter, 2021. "Estimating the costs of non-medical consumption in life-years gained for economic evaluations," Social Science & Medicine, Elsevier, vol. 289(C).
    14. Błażej Łyszczarz & Karolina Sowa, 2022. "Production losses due to mortality associated with modifiable health risk factors in Poland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 33-45, February.
    15. Islas-Aguirre, Juan Francisco & Venegas-Martínez, Francisco, 2024. "Interacción entre apoyos monetarios agrícolas y pobreza en los estados de mayor producción agrícola en México (2020), un enfoque de econometría espacial," Panorama Económico, Escuela Superior de Economía, Instituto Politécnico Nacional, vol. 19(40), pages 203-231, Primer se.
    16. Werner Brouwer & Pieter Baal & Job Exel & Matthijs Versteegh, 2019. "When is it too expensive? Cost-effectiveness thresholds and health care decision-making," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 175-180, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Erik Nord, 2011. "Discounting future health benefits: the poverty of consistency arguments," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 16-26, January.
    2. Ana Bobinac & Werner Brouwer & Job van Exel, 2011. "Discounting future health gains: an empirical enquiry into the influence of growing life expectancy," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 111-119, January.
    3. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.
    4. Angelina Lazaro & Ramon Barberan & Encarnacion Rubio, 2002. "The economic evaluation of health programmes: why discount health consequences more than monetary consequences?," Applied Economics, Taylor & Francis Journals, vol. 34(3), pages 339-350.
    5. Mareike Schad & Jürgen John, 2012. "Towards a social discount rate for the economic evaluation of health technologies in Germany: an exploratory analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 127-144, April.
    6. Arthur E. Attema & Han Bleichrodt & Olivier L’Haridon & Patrick Peretti-Watel & Valérie Seror, 2018. "Discounting health and money: New evidence using a more robust method," Journal of Risk and Uncertainty, Springer, vol. 56(2), pages 117-140, April.
    7. John Hutton, 2012. "‘Health Economics’ and the evolution of economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 13-18, January.
    8. Attema, Arthur E. & Brouwer, Werner B.F., 2009. "The correction of TTO-scores for utility curvature using a risk-free utility elicitation method," Journal of Health Economics, Elsevier, vol. 28(1), pages 234-243, January.
    9. Cairns, John, 2006. "Developments in discounting: With special reference to future health events," Resource and Energy Economics, Elsevier, vol. 28(3), pages 282-297, August.
    10. Alireza Mahboub-Ahari & Abolghasem Pourreza & Ali Akbari Sari & Trevor A Sheldon & Maryam Moeeni, 2019. "Private and social time preference for health outcomes: A general population survey in Iran," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    11. Karl Claxton & Mike Paulden & Hugh Gravelle & Werner Brouwer & Anthony J. Culyer, 2011. "Discounting and decision making in the economic evaluation of health‐care technologies," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 2-15, January.
    12. Hugh Gravelle & Werner Brouwer & Louis Niessen & Maarten Postma & Frans Rutten, 2007. "Discounting in economic evaluations: stepping forward towards optimal decision rules," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 307-317, March.
    13. Michael Spackman, 2011. "Government discounting controversies: changing prices, opportunity costs and systematic risk," GRI Working Papers 67, Grantham Research Institute on Climate Change and the Environment.
    14. Stefan A. Lipman & Arthur E. Attema, 2024. "A systematic review of unique methods for measuring discount rates," Journal of Risk and Uncertainty, Springer, vol. 69(2), pages 145-189, October.
    15. Kontodimopoulos, Nick & Niakas, Dimitris, 2008. "An estimate of lifelong costs and QALYs in renal replacement therapy based on patients' life expectancy," Health Policy, Elsevier, vol. 86(1), pages 85-96, April.
    16. Attema, Arthur E. & Brouwer, Werner B.F., 2013. "In search of a preferred preference elicitation method: A test of the internal consistency of choice and matching tasks," Journal of Economic Psychology, Elsevier, vol. 39(C), pages 126-140.
    17. Hugh Gravelle & Dave Smith, 2001. "Discounting for health effects in cost–benefit and cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 587-599, October.
    18. Francis Asenso‐Boadi & Tim J. Peters & Joanna Coast, 2008. "Exploring differences in empirical time preference rates for health: an application of meta‐regression," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 235-248, February.
    19. Weatherly, Helen & Drummond, Michael & Claxton, Karl & Cookson, Richard & Ferguson, Brian & Godfrey, Christine & Rice, Nigel & Sculpher, Mark & Sowden, Amanda, 2009. "Methods for assessing the cost-effectiveness of public health interventions: Key challenges and recommendations," Health Policy, Elsevier, vol. 93(2-3), pages 85-92, December.
    20. S. Höjgård & U. Enemark & C. H. Lyttkens & A. Lindgren & T. Troëng & H. Weibull, 2002. "Discounting and clinical decision making: Physicians, patients, the general public, and the management of asymptomatic abdominal aortic aneurysms," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 355-370, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:36:y:2018:i:7:d:10.1007_s40273-018-0672-z. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.