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Fairness in cost‐benefit analysis: A methodology for health technology assessment
Author(s) -
Samson AnneLaure,
Schokkaert Erik,
Thébaut Clémence,
Dormont Brigitte,
Fleurbaey Marc,
Luchini Stéphane,
Van de Voorde Carine
Publication year - 2018
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3515
Subject(s) - sophistication , ex ante , health technology , weighting , valuation (finance) , actuarial science , welfare , cost effectiveness analysis , economics , cost–benefit analysis , public economics , population , econometrics , health care , medicine , cost effectiveness , operations management , sociology , environmental health , political science , economic growth , market economy , social science , radiology , finance , macroeconomics , law
Summary 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.