Fairness in cost-benefit analysis: A methodology for health technology assessment

Anne Laure Samson, Erik Schokkaert, Clémence Thébaut, Brigitte Dormont, Marc Fleurbaey, Stéphane Luchini, Carine Van de Voorde

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)102-114
Number of pages13
JournalHealth Economics (United Kingdom)
Volume27
Issue number1
DOIs
StatePublished - Jan 2018

All Science Journal Classification (ASJC) codes

  • Health Policy

Keywords

  • antihypertensive treatment
  • cost-benefit analysis
  • distributional weights
  • equivalent income

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