TY - JOUR
T1 - Fairness in cost-benefit analysis
T2 - A methodology for health technology assessment
AU - Samson, Anne Laure
AU - Schokkaert, Erik
AU - Thébaut, Clémence
AU - Dormont, Brigitte
AU - Fleurbaey, Marc
AU - Luchini, Stéphane
AU - Van de Voorde, Carine
N1 - Funding Information:
The authors thank two anonymous referees and seminar audiences in Paris, York, and Leuven for many valuable comments. We gratefully acknowledge financial support from the Health Chair - a joint initiative by PSL, Université Paris Dauphine, ENSAE, MGEN and ISTYA under the aegis of the Fondation du Risque (FDR). The Health Chair is financed by MGEN, a nonprofit complementary health insurance organization for teachers in France, and by ISTYA, a federation of nonprofit complementary health insurance organizations for French civil servants. The rules monitoring the sponsorship by MGEN and ISTYA prevent any interference with research projects. In particular, the sponsors did not have any influence in study design, in the collection, analysis, and interpretation of data, and in the writing of the report, as well as in the decision to submit this paper.
Publisher Copyright:
Copyright © 2017 John Wiley & Sons, Ltd.
PY - 2018/1
Y1 - 2018/1
N2 - We evaluate the introduction of various forms of antihypertensive treatments in France with a distribution-sensitive cost-benefit analysis. Compared to traditional cost-benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well-being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population. Compared to traditional cost-effectiveness analysis in health technology assessment, we show that it is feasible to go beyond a narrow evaluation of health outcomes while still fully exploiting the sophistication of medical information. Sensitivity analysis illustrates the relevancy of this richer welfare framework, the importance of the distinction between an ex ante and an ex post approach, and the need to consider distributional effects in a broader institutional setting.
AB - We evaluate the introduction of various forms of antihypertensive treatments in France with a distribution-sensitive cost-benefit analysis. Compared to traditional cost-benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well-being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population. Compared to traditional cost-effectiveness analysis in health technology assessment, we show that it is feasible to go beyond a narrow evaluation of health outcomes while still fully exploiting the sophistication of medical information. Sensitivity analysis illustrates the relevancy of this richer welfare framework, the importance of the distinction between an ex ante and an ex post approach, and the need to consider distributional effects in a broader institutional setting.
KW - antihypertensive treatment
KW - cost-benefit analysis
KW - distributional weights
KW - equivalent income
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U2 - 10.1002/hec.3515
DO - 10.1002/hec.3515
M3 - Article
C2 - 28620934
AN - SCOPUS:85020550618
SN - 1057-9230
VL - 27
SP - 102
EP - 114
JO - Health Economics (United Kingdom)
JF - Health Economics (United Kingdom)
IS - 1
ER -