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. 2023 Nov 2;11(1):2275350.
doi: 10.1080/20016689.2023.2275350. eCollection 2023.

Discounting health gain: a different view

Baudouin Standaert  1 , Olivier Ethgen  2
Affiliations

Discounting health gain: a different view

Baudouin Standaert et al. J Mark Access Health Policy. .

Abstract

At least since the Age of Enlightenment, good health has been a tenet for society. Healthy societies could learn better, work harder, improve their wealth, and live longer. Today societies focus on life expectancy, as we value long and healthy lives. As illustrated by the provision of COVID-19 vaccines first for the elderly, societies value life-saving actions. Paradoxically, health economic assessments conventionally devalue long-lasting health through the practice of discounting health benefits along with costs. However, health, with its intrinsic and instrumental characteristics, is not synonymous with money cash, a tradeable asset that devalues with time. If improving healthy life expectancy is a societal ambition, it seems counter-intuitive to value future health less as a result of an artificial mathematical construct when evaluating economically new medical interventions. In this paper, we investigate the application of discounting health in healthcare and consider paradoxical findings, especially in relation to disease prevention with vaccination. We argue that there is no economically sustainable argument to discount health gains, except for the benefit of the payer with a goal of spending less on life-saving products. If that is the objective for discounting health, there are other means to achieve the same goal in a more transparent and simpler way. From the long-term perspective of healthcare development, not discounting health gains would encourage research that values long-term effects. This in turn has the potential to benefit the investor, the payer, and the patient/consumer, improving the situation from multiple perspectives.

Keywords: Discounting; economic assessment; health; vaccination.

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Conflict of interest statement

No potential conflict of interest was reported by the auhtors related to this work.

Figures

Figure 1.
Figure 1.
Money and utility gain flow of the consumer market.
Figure 2.
Figure 2.
Money and utility gain flow of the healthcare market.
Figure 3.
Figure 3.
From product to output and value in the consumer market.
Figure 4.
Figure 4.
Comparing price-setting in the ‘open’ consumer (A) versus the ‘non-market’ healthcare world (B).
Figure 5.
Figure 5.
Difference in relative price reduction as a function of health discount and timing of the QALY gain.
Figure 6.
Figure 6.
Changing other items (threshold (1) and cost (2)) to review price-setting in healthcare.
See this image and copyright information in PMC

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